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

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.