abstract and introduction
prologue
Since December 2019, approximately 12 million children and adolescents under the age of 18 in the United States have been infected with SARS-CoV-2, the virus that causes COVID-19*, and COVID-19-related hospitalization rates are It is increasing among children < . Five years during the B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant peaks.[1] In June 2022, the Food and Drug Administration amended the Emergency Use Authorization for the BNT162b2 (Pfizer-Biontech) COVID-19 vaccine to limit the use of the vaccine in children aged 6 months to 4 years and remove mRNA-1273 in children. (Moderna) included the use of 6. CDC recommends that all children receive it.† Preliminary reports indicated that less than 50% of parents were willing to vaccinate their children under 5 years of age.[2,3] Using pediatric studies to observe trends and exposures in the COVID-19 timeline (PROTECT)§ [4] Prospective cohort, COVID-19 vaccine and changes in parental perceptions of vaccination¶ Of the 393 parents who participated in the baseline survey, approximately 64%, 19%, and 10% reported likely, unsure, or unlikely, respectively. Have a child under the age of 5 get her COVID-19 vaccine.The odds of a parent intending to vaccinate their child were lower after her 3 months of baseline study (adjusted odds ratio [aOR] = 0.84, 95% CI = 0.6–1.0) than at baseline. Over the same period, parents found the COVID-19 vaccine to be effective (aOR = 0.61, 95% CI = 0.4–0.8) and safe (aOR = 0.65, 95% CI = 0.5–0.9) compared to baseline were less likely to recognize In the unadjusted model, vaccination intentions and safety perceptions increased 6 months after the baseline survey (OR = 1.66, 95% CI = 1.1–2.5; and OR = 1.82, 95% CI, respectively). = 1.3–2.6). Importance that the child received her positive SARS-CoV-2 test result before the study was completed, after adjusting for age, sex, race and ethnicity, health insurance, and study location. Intensified efforts to address parental confidence in childhood vaccination and increase vaccination coverage for children under the age of five, including strengthening the efficacy and safety of vaccination against COVID-19. Is required.
PROTECT is an ongoing, prospective cohort involving over 2,300 children and adolescents aged 4 months to 17 years. This study monitors SARS-CoV-2 transmission in Arizona, Florida, Texas, and Utah.[4] Children were recruited through community outreach from the general public and from families participating in the HEROES-RECOVER longitudinal cohort of essential frontline workers.[5,6] At enrollment, parents provided sociodemographic information, COVID-19 medical history, immunization history, and awareness of their child’s COVID-19 vaccine. Participants will be surveyed every three months. SARS-CoV-2 infection is identified among participating children through mid-turbinate specimens collected weekly and tested via reverse transcription-polymerase chain reaction. Parents who completed the baseline survey and at least one of her follow-up surveys were included in the analysis. One child was randomly selected from households with two or more children under the age of five to avoid clustering of households. The study was limited to her 393 children under the age of 5 who were enrolled in her PROTECT study between July 2021 and her May 2022. [child] Responses were grouped into three categories: unlikely (nearly unlikely, very unlikely), unknown (unlikely, don’t know, moderately likely), likely High (likely, very likely, very likely, almost certain).
A generalized estimating equations (GEE) model was used for each question to determine whether within-parent responses were neutral or negative (unknown or unlikely) at 3 and 6 months after the baseline enrollment survey. ) to a positive response. All surveys available from participants in the analysis group were included in the GEE model. Survey time point was added as a categorical predictor to calculate the OR of vaccine intention and vaccine awareness. Moreover, the OR indicates the likelihood that all participants provided more positive responses in the 3- and 6-month surveys compared to the baseline survey. Both unadjusted and adjusted models were calculated. The adjusted model included surveys, sociodemographic characteristics, and positive testing for SARS-CoV-2 infection in children across study sites. For the vaccination intention outcome, his GEE model with multinomial distribution and cumulative logit link was used. Other models evaluating perceptual outcomes used the binomial distribution and the logit link. All statistical analyzes were completed using SAS (version 9.4; SAS Institute). Statistical significance was defined as p < 0.05 for the chi-square test and 95% CI for non-duplicates for the GEE model. PROTECT was reviewed by the CDC and approved by the University of Arizona Institutional Review Boards and Abt Associates under a trust agreement. This study was conducted in accordance with applicable federal law and CDC policy. **
Between July 2021 and May 2022, parents provided information on 393 children under 5 years of age enrolled in the PROTECT study (table 1). Most children (227, 58%) resided in Arizona, and 92 (23%) had parents from her HEROES-RECOVER cohort.[5,6] The median age was 2.8 years (SD = 1.3 years). 189 (48%) were male, 183 (47%) were non-Hispanic white, and 110 (28%) were Hispanic. 132 (34%) children had positive SARS-CoV-2 test results in her during the study. At baseline, 253 (64.4%) parents reported that their children were likely to be vaccinated. 76 (19.3%) were unsure and 39 (9.9%) reported that they would be unlikely to vaccinate their children (table 1). Vaccine intent identified by study site (p<0.001), positive SARS-CoV-2 test results during study (p = 0.006), proportion of household members vaccinated (p = 0.011), and households Income (p = 0.003).
About two-thirds (270; 68.7%) of the participants completed the 3-month study and 137 (34.9%) completed the 6-month study (Table 2) (shape). Of the parents who completed the 3-month survey, 11 (4.1%) changed their vaccination intentions from neutral or negative responses to positive responses after 3 months, whereas overall parents 24% less likely to be vaccinated (aOR = 0.76). Base line. Also, after 3 months, 30 (11.2%) parents changed their perception of vaccine effectiveness from neutral or negative to positive, but overall, the chances of them perceiving the vaccine as effective were less than she 39% lower (aOR = 0.61). After her 3 months of baseline survey, 29 (10.9%) parents changed their perception of vaccine safety from neutral or negative to positive. However, she was 35% less likely to be recognized by the overall caregiver as safe (aOR = 0.65). When asked about their perceptions of trust in government, 28 (10.7%) parents changed from negative or neutral responses to positive responses after 3 months, although their trust in government was lower than baseline. were 51% less likely to report (aOR = 0.49). .
shape.
Distribution of 3- and 6-Month Surveys by Survey Month — Trends and Exposures in Pediatric Research Observations in the COVID-19 Timeline Cohort, 4 States, October 2021-May 2022
Of the 137 parents who completed the 6-month study, 11 (8.1%) changed their perception of vaccine efficacy from neutral or negative to positive (Table 2); overall parents were 62% less likely to have a positive response (aOR = 0.38) regarding vaccine efficacy. 11 (8.4%) parents changed their level of trust in government from negative or neutral to positive, but overall parents were 49% less likely to respond positively (aOR = 0.51). In the unadjusted model only, intent to vaccinate and perceptions of vaccine safety were less likely to be neutral or negative at 6 months (OR = 1.66 and OR = 1.82, respectively). Positive SARS-CoV-2 test results before the completion of the 6-month study, after adjusting for age, sex, race and ethnicity, health insurance, and site, were not statistically significant. lost.
