Objective

To measure the risk of influenza under-vaccination in children of vaccine-hesitant parents, referent to children of nonhesitant parents, in a sample of disadvantaged families in one influenza season.

Study Design

A prospective observational cohort study of English- and Spanish-speaking parents of 2-year-olds presenting at random for well, sick, or specialty visit care from August 1, 2019 to February 28, 2020. Parents answered demographic questions and the Parent Attitudes about Childhood Vaccines survey. We followed children until season's end, extracting vaccination data on April 30, 2020. We dichotomized vaccination status as unvaccinated or partially/fully vaccinated, analyzing data with multivariable Poisson regression; in secondary analyses, we conducted adjusted time-to-event analyses.

Results

Overall, 263 parents consented (response rate: 90%); our final sample included 255 dyads. Thirty-three (13%) parents were vaccine hesitant. In adjusted analyses, children of hesitant parents (n = 33) had a 195% increased risk (adjusted Risk Ratio 2.95; 95% confidence interval 1.91, 4.56) of being unvaccinated at season's end, referent to children of nonhesitant parents (n = 222). In time-to-event analyses, children of vaccine-hesitant parents were also more likely to be unvaccinated before influenza activity peaked (P = .02).

Conclusions

Parental vaccine hesitancy tripled the risk of pediatric influenza nonvaccination in a sample of poor and minority families during the 2019 to 2020 influenza season. As parental vaccine hesitancy appears to exacerbate pediatric influenza vaccination disparities, future work should explore parental hesitancy with poor and minority stakeholders and tailor evidence-based interventions to benefit children from these communities who receive care at all practice sites.

中文翻译：

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安全网卫生保健系统中父母接种疫苗的犹豫和儿童流感疫苗接种不足的风险

客观的

在一个流感季节的弱势家庭样本中，衡量对疫苗犹豫不决的父母的孩子（参考不犹豫的父母的孩子）的流感疫苗接种不足的风险。

学习规划

对 2019 年 8 月 1 日至 2020 年 2 月 28 日期间随机就诊的 2 岁儿童的讲英语和西班牙语的父母进行的一项前瞻性观察队列研究。父母回答了人口统计问题和父母态度关于儿童疫苗调查。我们跟踪儿童直到赛季结束，在 2020 年 4 月 30 日提取疫苗接种数据。我们将疫苗接种状态分为未接种疫苗或部分/完全接种疫苗，并使用多变量泊松回归分析数据；在次要分析中，我们进行了调整后的事件发生时间分析。

结果

总体而言，263 位家长同意（回应率：90%）；我们的最终样本包括 255 个二元组。三十三个 (13%) 的父母对疫苗犹豫不决。在调整后的分析中，犹豫父母 (n = 33) 的孩子在季节结束时未接种疫苗的风险增加了 195%（调整后风险比 2.95；95% 置信区间 1.91, 4.56），指的是犹豫不决的父母（n = 222）的孩子）。在事件时间分析中，对疫苗犹豫不决的父母的孩子也更有可能在流感活动达到峰值之前未接种疫苗 ( P  = .02)。

结论

在 2019 年至 2020 年流感季节期间，在贫困和少数民族家庭样本中，父母对疫苗的犹豫使儿童未接种流感疫苗的风险增加了两倍。由于父母对疫苗的犹豫似乎加剧了儿科流感疫苗接种的差异，未来的工作应该与贫困和少数族裔利益相关者一起探索父母的犹豫，并定制循证干预措施，以使这些社区的儿童在所有实践场所接受治疗。