Abstract

Abstract Background Although COVID-19 vaccination has been recommended for all children 6 months of age and older since August 2022, vaccine uptake among the pediatric population is low. Underlying caregiver attitudes towards pediatric COVID-19 vaccination have not been adequately classified or described. A better understanding of how caregiver attitudes influence household vaccination behavior can help tailor future vaccine interventions. Methods Unvaccinated children aged 18 months to 11 years underwent antibody testing and their caregivers were asked to complete an electronic survey at four clinic-based practices in Northern and Central NJ from September 2022 to April 2023. Information was collected on household exposures, vaccination status, COVID-19 infection, and caregiver beliefs about pediatric vaccination. Latent class analyses were conducted to group caregivers into four distinct profiles based on how safe, effective, useful and necessary they felt vaccination was. Results A total of 656 survey participants were grouped into a vaccine acceptance class based on their level of agreement on each attitudinal item, from low to high. Those in Class 1 had the most disagreement and lowest vaccine acceptance; those in Class 4 had the most agreement and highest vaccine acceptance. The majority of the sample fit into Class 2 (39%), indicating moderate disagreement and low COVID-19 vaccine acceptance. Caregivers in the lowest vaccine acceptance classes (1 & 2) were significantly less likely to plan to vaccinate their children compared to those in higher classes (3 & 4); (9.8% and 5.5% vs. 31.9% and 61%). Those in Class 2 were significantly less likely to have at least one adult household member fully vaccinated or boosted against COVID-19 than those in higher classes; and were significantly more likely to be from households where at least one adult was diagnosed with COVID in the past year than those in Class 3 (54.2% vs 37.7%). Conclusion Caregiver attitudes towards vaccination, and inclusion in vaccine acceptance classes, is closely associated with household vaccination status and COVID-19 infection history. Educational efforts and messaging should target the different aspects of caregiver profiles to address vaccine hesitancy and make future vaccine programming for children more successful. Disclosures Joseph V. Schwab, MD, MPH, Bristol-Myers Squibb: Stocks/Bonds|GE Healthcare: Stocks/Bonds|Johnson and Johnson: Stocks/Bonds

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