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COVID-19 Vaccination in Historically Marginalized Communities: Examining Barriers and Facilitators in a Pediatric
Marquita C Genies1, John O Loftus2, Anna C Sick-Samuels3
1Division of Hospital Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
COVID-19 vaccination hesitancy is high in marginalized communities, with parents citing unknown side effects and rapid vaccine development as key barriers. Trust in healthcare providers may encourage vaccination in children.
Area of Science:
- Pediatric Health
- Vaccinology
- Public Health
Background:
- COVID-19 hospitalization rates are significantly higher in unvaccinated children compared to vaccinated children.
- This disparity is more pronounced among racial and ethnic minority children.
- Vaccination rates among children remain suboptimal, with limited research on barriers in marginalized communities.
Purpose of the Study:
- To characterize barriers to COVID-19 vaccination among parents/guardians in historically marginalized communities.
- To explore perceptions of COVID-19 vaccines and trusted information sources.
- To understand vaccination intentions for children aged 12 months to 18 years.
Main Methods:
- A survey was conducted from January to May 2022.
- Participants included parents/guardians of children presenting for pediatric care at a hospital-based primary care clinic.
- The survey focused on vaccine perceptions, intentions, and trusted information sources.
Main Results:
- 92% of the 113 participants identified with a historically marginalized racial/ethnic group.
- 54% of respondents were hesitant or unsure about vaccinating their child.
- Common barriers included concerns about unknown side effects, rapid vaccine development, unsafe ingredients, experimental use, and fertility impacts.
- Parents planning to vaccinate showed higher trust in healthcare providers and institutions.
Conclusions:
- Significant COVID-19 vaccine hesitancy exists among parents in historically marginalized groups.
- Concerns regarding vaccine safety and development are primary barriers.
- Trust in healthcare providers is a potential facilitator for increasing pediatric COVID-19 vaccination rates.
- Pediatric healthcare providers need enhanced training to address specific parental concerns and improve vaccination uptake.
Introduction:
COVID-19 hospitalization rates among unvaccinated children are double of that of vaccinated children, and this difference is greater among racial and ethnic minority children. Vaccination rates among children remain suboptimal. Few studies have characterized barriers to COVID-19 vaccination among historically marginalized communities.
Methods:
From January 2022 to May 2022, parents and guardians of children aged 12 months to 18 years presenting for pediatric care at a hospital-based primary care clinic were surveyed about perceptions of COVID-19 vaccines, intentions to vaccinate their child, and trusted sources of information.
Results:
A total of 113 parents/guardians participated, with 92% self-identifying with a historically marginalized racial/ethnic group. A total of 54% of respondents either did not plan to vaccinate their child against COVID-19 or were unsure. The obstacles to vaccination most frequently cited were related to (1) unknown side effects, (2) the rapid development of the vaccine, and (3) unsafe ingredients. Worries about being used as experimental subjects and potential impacts on fertility were also reported. Parents who planned to vaccinate their child reported higher rates of trust in doctors, local clinics, hospitals, and health departments.
Conclusions:
High rates of COVID-19 vaccination hesitancy exist among parents/guardians from historically marginalized groups. Barriers to vaccination were frequently related to side effects, whereas a high level of trust in healthcare providers as sources of information may be a facilitator. Strategies to improve health outcomes and boost vaccination rates should focus on equipping pediatric healthcare providers with the knowledge and skills necessary to address these known barriers to COVID-19 vaccination.
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