Related Experiment Video
Updated: Jul 8, 2025
Nasal Brushing Sampling and Processing Using Digital High Speed Ciliary Videomicroscopy – Adaptation for the COVID-19 Pandemic
Published on: November 7, 2020
Understanding paediatric COVID-19 vaccination during the pandemic: a prospective cohort and a population-based
Yanyan Ni1, Francis P Flores1, Phyllis Lun1
1School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Insights
School mandates and vaccine passes significantly increased COVID-19 vaccine uptake in children. Addressing factors like political views and mistrust can improve future pandemic vaccination efforts.
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- COVID-19 vaccine uptake in children has been low globally despite proven safety and effectiveness.
- Understanding reasons for vaccine refusal is crucial for improving immunization rates during pandemics.
Purpose of the Study:
- To evaluate the impact of public policies on pediatric COVID-19 vaccination rates.
- To identify determinants of vaccine hesitancy and refusal in children and adolescents.
- To explore modifiable factors influencing vaccine uptake.
Main Methods:
- Interrupted time series analysis of a population-wide registry of COVID-19 pediatric vaccination appointments.
- Population attributable fractions to assess determinants of vaccination.
- Mediation analysis to examine factors linking political views to vaccination reluctance.
Main Results:
- School vaccination requirements increased adolescent vaccination by 278.7% and younger children by 112.8%.
- Government vaccine passes boosted adolescent vaccination appointments by 108.7%.
- Familial political views, vaccine hesitancy, mistrust, and misconceptions explained 82.5% of unvaccinated cases, with political influence mediated by mistrust and low confidence.
Conclusions:
- School vaccination requirements and vaccine passes are effective public health interventions for increasing pediatric COVID-19 vaccine uptake.
- Non-health factors, including political views, significantly impact vaccine acceptance and can be mitigated through targeted interventions and policies.
Background:
Despite the early demonstrated safety and effectiveness of COVID-19 vaccines in children, uptake was slow throughout the pandemic and remains low globally. Understanding vaccine refusal could provide insights to improving vaccine uptake in future pandemics.
Methods:
In a population-wide registry of all COVID-19 paediatric vaccination appointments, we used interrupted time series analysis to evaluate the impact of public policies. In a population-based cohort of adults, we used population attributable fractions to assess the individual and joint contributions of potential determinants to paediatric COVID-19 vaccination, and used mediation analysis to identify modifiable mediators between political views and paediatric vaccination.
Findings:
School vaccination requirements were associated with an increase in vaccination appointments by 278.7% (95% CI 85.3-673.9) in adolescents aged 12-17 and 112.8% (27.6-255.0) in children aged 5-11. Government-mandated vaccine pass, required for entry into restaurants, shopping malls and supermarkets, was associated with increased vaccination appointments by 108.7% (26.6-244.0) in adolescents. The following four determinants may explain 82.5% (63.5-100.0) of the reasons why children were unvaccinated: familial political views, vaccine hesitancy for children, mistrust in doctors and academics, and vaccine misconceptions. The influence of political views may be mitigated since 95.9% (76.4-100.0) of its association with vaccine reluctance for adolescents was mediated by modifiable factors such as mistrust in health authorities and low vaccine confidence.
Interpretation:
School vaccination requirements and vaccine passes were associated with increased vaccine uptake. Clinicians should recognise that factors beyond health, such as political views, can influence paediatric vaccine uptake to a significant extent. Nonetheless, such influences could be mitigated by targeted interventions and public policies.
Funding:
Hong Kong Jockey Club Charities Trust, Research Grants Council, University Grants Committee, and Health Bureau.
Related Concept Videos
01:51Vaccinations
01:30Pneumonia III: Complications and Assessment
01:17Ethical Dilemmas I
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...
01:31Active versus Passive Immunity
Active Immunity
Active immunity refers to the resistance one develops...