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22. Vaccines for Teens: Attitudes Across the Pandemic on Routine and COVID-19 Vaccines

      Purpose

      Given the increase in vaccine hesitancy, Unity Consortium surveyed adolescents and parents of adolescents across three time points during the Pandemic to evaluate factors associated with vaccine attitudes and acceptance of COVID-19 vaccines prior to its availability, after availability for adults, and after availability for adolescents ages 12+.

      Methods

      A third-party market research company conducted 15-minute, online surveys of teens ages 13-18 and parents/guardians of teens ages 13-18 from nationally representative panels. The surveys were conducted in three waves: 8/2020, 2/2021, and 6/2021. Waves 1, 2, and 3 included 300 teens each and 593/531/500 parents, respectively. The main topics included: experiences with COVID-19; ratings of importance of adolescent vaccines; and intentions regarding COVID-19 vaccination. Data were analyzed for differences across waves and demographic variables. Statistical analyses included frequencies and analysis of variance (ANOVA) and t-tests/z-tests.

      Results

      Parent ratings of the importance of teen vaccines were high across survey waves – 83-85% for Tdap, 80-84% for MenACWY/MenB and 74-78% for HPV. Ratings for COVID-19 ranged from 66-74%. Urban and suburban respondents showed stronger agreement than rural respondents with the importance of vaccines. The proportion of parents reporting concerns about vaccine safety rose from Wave 1 (52%) to Wave 2 (63%, p<0.05). Over half of teens and approximately 50% of parents reported increasing concern across survey waves about vaccine safety due to what they have read on social media. By Wave 3, 56% of parents and 58% teens had received COVID-19 vaccine with pharmacy as the most common vaccination site. Self/family protection was consistently the leading motivation for getting the COVID-19 vaccine, and concern about side effects was the leading reason for not getting the vaccine, rising significantly across waves to approximately 6 in 10 of both parents and teens. Of parents whose teen was not yet vaccinated against COVID-19, 33% said they do not plan to do so. Within this group of parents, non-Hispanic (35% v. 26% Hispanic, p<0.05) and rural (46% v. 26% urban, p<0.05) parents were more likely to not vaccinate their teen. Demographic factors significantly associated with teens being vaccinated by Wave 3 included being from an urban community, Asian race, higher household income and living in the Northeast. Hispanic ethnicity and age of the teen (median age 15 years) were not associated. Of note, 70% of parents were willing to vaccinate their teen with other vaccines at the same time as Covid-19 vaccine; the most common reason for not doing so was that the teen was already up-to- date.

      Conclusions

      Across the time course of the pandemic, concerns related to vaccine safety in general and the safety of COVID-19 vaccine increased, and parents and teens increasingly acknowledge a negative influence of social media on their opinions about vaccine safety. Over half of parents and teens have received the vaccine, and parents are willing to accept concomitant vaccines for their teen. It will be important to address issues of inequity manifested by demographic differences in COVID-19 vaccine uptake among teens.

      Sources of Support

      The survey is funded by Unity members including vaccine manufacturers.