PM2071: Addressing COVID-19 Disparities- understanding Patient-guardian COVID-19 Vaccination Perspectives Among Racial and Ethnic Minority Groups

Background: In the United States, coronavirus disease (COVID-19) disproportionately affects racial/ethnic minorities across all age groups. COVID-19 vaccination for children is essential for individual and community protection. In April 2022, children represent about 17.3% of reported weekly COVID-19 cases. Hospitalization rates among unvaccinated children aged 5-11 was almost twice that of vaccinated children during the Omicron surge, and a majority were African American. According to the CDC, current vaccination rates in eligible children aged 5-17 years are lower than expected and insufficient. Hesitancy towards vaccination poses a challenge to its utility in reducing the morbidity and mortality of COVID-19 disease in marginalized populations. Our study aims to understand barriers and facilitators of COVID-19 vaccination uptake among racial/ethnic minority groups.

Methods: We are currently conducting a mixed-methods study (questionnaire surveys and semi-structured interviews) to understand the barriers and facilitators of COVID-19 vaccination among parents-guardians of eligible children aged 12 months to 18 years who receive pediatric primary care at a resident-run clinic that serves greater than 90% racial-ethnic minority children of which about 90% are publicly insured. We used descriptive statistics and aim to complete multivariate analyses to elucidate drives and inhibitors of COVID-19 vaccine uptake. For analysis, patients were grouped into 3 age cohorts - 12 months to < 5 years, ³ 5 to < 12 years and ³ 12 to 18 years of age.

Results: Among the 75 respondents, 84% were African American, 80% had a high school diploma or some college education, 31% previously had a positive COVID-19 test and 67% were fully vaccinated. Of our cohort only 39% (n=15) of children 5 years and older were vaccinated against COVID-19. 77% of parents of children < 5 years, 76% for children 5-11 and 60% for children 12-17 years of age responded that they did not intend to/were unsure about vaccinating their child. Despite this 82% felt that vaccination is important for resolving the pandemic, 56% felt that vaccines are safe, and 50% felt vaccines decrease chances of getting COVID-19. Key barriers to vaccination included worries about vaccine: side effects (64%), having developed too quickly (54%), ingredients unknown or unsafe ingredients (54%), affecting childrens' fertility (49%) and perceptions of being experimented on (44%).

Conclusion: Respondents have widespread distrust of COVID-19 vaccine and uncertainty around vaccine safety for their children. The barriers identified in this survey are important to consider when tailoring programming to increase COVID-19 vaccination among racial/ethnic minority groups.