Parental Vaccine Hesitancy and Risk of Pediatric Influenza Under-Vaccination in a Safety-Net Health Care System
Section snippets
Design, Setting, and Population
We performed a prospective observational cohort study of English- and Spanish-speaking parents bringing their 2-year-old children to 3 pediatric, urban, safety-net clinics within the Denver Health system (Denver, Colo) for well or sick care during the 2019 to 2020 influenza season. We chose 2-year-old children because they are at high risk of influenza complications21 and should have completed the routine primary series of vaccines, leaving parents to decide only about the yearly influenza
Results
During the recruitment period, 2850 2-year-olds had recorded visits at the 3 recruiting clinics. We approached 293 parents for participation in the study; 263 parents consented (response rate of 90%). Two parent surveys were incomplete, and 6 children were recruited twice on separate occasions. Our final sample included 255 dyads, representing ~9% of all 2-year-olds visiting the 3 clinics during the recruitment period. Table 1 demonstrates similar demographic characteristics for participating
Discussion
This study documents how parental vaccine hesitancy impacted pediatric influenza vaccination for children of English and Spanish-speaking parents in a safety-net system. Overall, in adjusted analyses, we found that poor and minority children of hesitant parents were significantly less likely to be vaccinated by both peak influenza activity and season's end, compared to children of nonhesitant parents.
We found that poor and minority children of vaccine hesitant parents were 3 times more likely
Conclusions
Caregiver vaccine hesitancy tripled the risk of nonvaccination for 2-year-olds in a safety-net system during the 2019 to 2020 influenza season. Additionally, many children of nonhesitant parents were still unvaccinated before peak influenza activity. In a SARS-CoV-2 pandemic disproportionately affecting minority communities, seasonal pediatric influenza vaccination in safety-net systems is imperative to avert further inequities. Future work should explore influenza vaccine hesitancy in poor and
Acknowledgments
Financial statement: This work was supported by a Denver Health Junior Investigator Research Award, sponsored by the Denver Health Foundation.
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Conflict of Interest: All authors report no conflict of interest, real or perceived, relevant to: 1) study design; 2) the collection, analysis, and interpretation of data; 3) the writing of the report; and 4) the decision to submit the paper for publication.