Evaluating Teen-Parent Dynamics in Adolescent COVID-19 Vaccine Acceptance and Uptake

项目摘要 尽管在COVID-19大流行的早期，大多数住院和死亡发生在成年人中， 自从德尔塔变异体在美国出现以来，青少年的住院率稳步上升。 2021年6月至8月期间，青少年COVID-19的住院率增加了五倍。在 除了COVID-19的直接健康后果外，青少年是减轻 传播SARS-CoV-2病毒。初中和高中的重新开放创造了额外的 COVID-19在社区持续传播的机会， 感染是控制COVID-19公共卫生优先事项。 建议所有12岁及以上的人接种COVID-19疫苗，以降低感染风险 以及青少年因COVID-19住院治疗。尽管有公共卫生方面的好处，免疫接种率仍然很低。 在美国青少年中并不理想。截至2021年7月31日，42%的12-17岁美国青少年 接种了≥1剂COVID-19疫苗，32%完全接种。这些利率远低于 全国平均76%的12岁以上美国人口接种过1剂以上COVID-19疫苗， 65%完全接种疫苗。从历史上看，提高青少年疫苗覆盖率的干预措施几乎 专门针对父母。因此，我们目前对疫苗犹豫的理解很差， 青少年以及这与疫苗决策的关系。鉴于a）COVID-19免疫接种率低 在青少年中观察到，B）事实上，超过30%的青少年报告参与疫苗接种 （c）最近扩大了允许青少年同意接种疫苗的国家政策， 检查联合和独立的青少年和父母的疫苗态度，以及这些态度如何推动 为了更有效地控制COVID-19的传播，迫切需要疫苗的接受。 通过创新的数据收集方法和对现有统计框架的新应用， 我们的目标是i）验证一种用于监测青少年对COVID-19疫苗犹豫不决的测量工具， 父母，ii）确定这种犹豫如何在青少年和他们的父母之间相互关联，iii）评估如何 青少年和父母的疫苗犹豫在决定接种COVID-19疫苗时相互作用。 与多层次干预相比，专门针对父母的干预不太可能有效 针对青少年及其父母。此应用程序生成的证据将用于开发 这样的干预。今后，这一框架可用于提高对其他建议的采用， 青少年疫苗

PROJECT SUMMARY Although early in the COVID-19 pandemic, the majority of hospitalizations and deaths occurred among adults, since the rise of the delta variant in the US, hospitalizations among adolescents have steadily increased. Between June and August 2021, the hospitalization rate for adolescents with COVID-19 increased five-fold. In addition to the direct health consequences of COVID-19, adolescents are a key group for mitigating the transmission of the SARS-CoV-2 virus. The reopening of middle and high-schools creates additional opportunities for sustained transmission of COVID-19 in the community, making prevention of adolescent infection a public health priority for COVID-19 control. COVID-19 vaccination is recommended for all individuals 12 years and older and reduces the risk of infection and adolescent hospitalization with COVID-19. Despite the public health benefits, immunization rates are suboptimal among US adolescents. As of July 31, 2021, 42% of US adolescents aged 12-17 years old have received ≥1 dose of the COVID-19 vaccine and 32% were fully vaccinated. These rates fall well below the national average of 76% of the US population ≥12 years of age with ≥1 dose of the COVID-19 vaccine and the 65% fully vaccinated. Historically, interventions to improve adolescent vaccine coverage have almost exclusively targeted parents. As a result, we currently have a poor understanding of vaccine hesitancy among adolescents and how this relates to vaccine decision-making. Given a) poor COVID-19 immunization rates observed among adolescents, b) the fact that more than 30% of adolescents report being involved in vaccine decision-making, and c) the recent expansion of state policies to allow adolescent consent to vaccination, examination of joint and independent adolescent and parental vaccine attitudes and how these attitudes drive vaccine acceptance is critically needed to more effectively control the spread of COVID-19. Through an innovative approach to data collection and novel application of an existing statistical framework, we aim to i) validate a measurement tool for monitoring COVID-19 vaccine hesitancy in adolescents and their parents, ii) identify how this hesitancy correlates between adolescents and their parents and iii) evaluate how adolescent and parental vaccine hesitancy interacts in the decision to vaccinate against COVID-19. Interventions that exclusively target parents are less likely to be effective compared to multilevel interventions targeting both adolescents and their parents. Evidence generated by this application will be used to develop such interventions. In future, this framework could be applied to improve uptake of other recommended adolescent vaccines.