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Promoting Childhood Vaccination During the COVID-19 Pandemic

Authored by Tess Thompson, SPI Faculty Affiliate & Research Assistant Professor, Brown School and Amy McQueen, Professor of Medicine & Co-Director of the Health Communication Research Lab

As schools start back up, many parents are concerned about the health effects of COVID-19 in children. However, childhood diseases beyond COVID-19 are still threats to children’s well-being. In the early stages of the pandemic, there was a large decrease in childhood vaccination rates for diseases such as diphtheria, pertussis, measles and mumps. A new study from Washington University’s Health Communication Research Lab and the Centene Center for Health Transformation sheds some light on the attitudes of parents/guardians toward childhood vaccinations during the pandemic, as well as what health care providers can do to keep kids up-to-date.

Understanding low-income parents’ perception of childhood vaccination

The researchers partnered with Florida’s Sunshine Health Plan to survey parents or guardians whose children ages 0-5 were covered by Medicaid, a U.S. health insurance program for low-income individuals. Researchers developed a survey together with health plan representatives to find out how parents were thinking about childhood vaccination during the pandemic. Parents/guardians completed a brief online survey and received a Walmart e-gift card as a thank-you. 

A total of 1,951 people responded to the survey in January 2021. The sample was mostly female (96%) and racially/ethnically diverse (29% Hispanic, 27% non-Hispanic white, 25% non-Hispanic Black). If participants had more than one child age 0-5-years-old they were asked to answer the questions in regards to their youngest child.

Parents express discomfort with taking their children to the doctor

Overall, respondents expressed widespread support for vaccination against childhood illnesses. Over 9 out of 10 respondents agreed that vaccines are important, useful and easy to do. Only about 2 out of 10 thought that vaccines were expensive. More than 9 in 10 respondents said their child was up-to-date with childhood vaccinations, but only about one-third said their child had received a flu vaccine.

A substantial minority of respondents expressed concerns about taking their child to the doctor. Almost one-third said there was a time during the pandemic when they wanted to take their child to the doctor but did not and more than 2 in 10 reported not being comfortable with in-office visits during the pandemic. Perhaps unsurprisingly, parents who were not comfortable with in-office visits were also less likely to report their child was up-to-date with vaccines. 

Parents and guardians were asked what strategies would make them more likely to take their children to the doctor during the pandemic. Respondents showed considerable support for having staff clean the exam room right before appointments, requiring adults to wear masks in the doctor’s office, temperature screening at the doctor’s office, allowing people to wait in their cars until the doctor is ready to see them and reserving certain days/times for healthy children to receive vaccines. Nearly half of people who had more than one child said that having childcare for older children would help them take their child to get vaccinated. 

 Low-income parents and guardians value vaccinations, yet pandemic anxieties may be stopping parents from seeking care for their children. “Healthcare providers need to do everything they can to reach out to parents and guardians who may be hesitant about taking their kids to the doctor and reassure them about office safety,” said Dr. Amy McQueen, one of the lead researchers. Adding flexibility and additional safety measures could help may help parents and guardians keep their kids up-to-date with preventive care.

This research blog discusses findings from the working paper “Vaccination Options for Medicaid Parents Uncomfortable with Office Visits during COVID Pandemic” funded by the Centene Center for Health Transformation.