带状疱疹疫苗接种药物经济学研究系统评价

目的 系统评价带状疱疹（herpes zoster,HZ）疫苗接种药物经济学研究,为相关研究及HZ的预防提供参考。方法 以“带状疱疹”、“带状疱疹疫苗”、“药物经济学”、“经济学评价”、“成本–效果分析”及“herpes zoster”、“herpes zoster vaccines”、“pharmacoeconomics”、“cost-effectiveness analysis”等为主题词,检索4个中文数据库和4个英文数据库自建库至2023年1月有关带状疱疹疫苗接种的药物经济学研究文献,由2名研究者对检索出的文献进行2次独立筛选;参照世界卫生组织《免疫规划项目的经济学评价标准指南》提取纳入文献的相关信息,采用《卫生经济学评价报告标准共识2022年》（Consolidated Health Economic Evaluation Reporting Standards,CHEERS2022）评价纳入文献带状疱疹疫苗接种药物经济学研究质量,对研究角度、模型结构、参数选择、评价结果和敏感性分析等进行描述性分析和定性系统评价。结果 共纳入43篇带状疱疹疫苗接种药物经济学研究英文文献,发表时...     

HIV疫苗接种策略经济学评价的综合分析

目的 概述全球HIV疫苗接种策略相关的经济学评价研究，为HIV疫苗接种有关决策和研究提供参考。方法 中文以“艾滋病或获得性免疫缺陷综合征”和“疫苗”和“经济学评价或成本效果分析或成本效用分析或成本效益分析”，英文以“Human immunodeficiency virus（HIV） or Acquired immunodeficiency syndrome（AIDS）”和“vaccine or vaccination”和“economic evaluation or cost-effectiveness analysis or cost-utility analysis or cost-benefit analysis or Health technology assessment（HTA）”3组检索词分别组合，在万方数据知识服务平台（万方）、中国医院知识仓库（CHKD）和PubMed数据库，检索截至2022年7月31日的HIV疫苗接种策略经济学评价相关文献，并对文献进行质量评估和综合分析。结果 共纳入17篇质量评估良好的文献，综合分析结果提示，无论是艾滋病重点人群或全人群，接种HIV疫苗是节省成本或具有成本效果的策略，可有效减少新发感染并提高人群生命质量。疫苗的有效率、覆盖率、价格和接种后风险性行为的变化等因素影响不同目标人群的接种效果。结论 目前HIV疫苗接种策略经济学评价的高质量研究数据较少，研究者可基于真实世界证据开展深入研究。     

Oka株水痘减毒疫苗免疫水痘发病的现场观察

  目的  对2004年2月 — 2021年11月国内外水痘疫苗不同免疫策略经济学研究进行质量评价,为我国水痘疫苗免疫策略和免疫规划决策提供参考。   方法  以“水痘疫苗”、“经济学评价”、“成本”、“成本效果”、“成本效用”、“成本效益”、“varicella vaccine”、“economic evaluation”、“cost”、“cost-benefit”、“cost-effect”、“cost-utility” 为检索主题,检索3个中文数据库和6个英文数据库,对检索出的文献进行2次筛选,参照世界卫生组织《免疫规划项目的经济学评价标准指南》提取纳入文献中的相关信息,采用卫生经济研究质量评价工具（quality of health economic studies,QHES）对2004年2月 — 2021年11月国内外水痘疫苗不同免疫策略经济学研究进行质量评价,并综合分析评价结果。   结果  共纳入13篇文献,其中中文文献4篇、英文文献9篇。分析结果显示,与不接种水痘疫苗相比,接种1剂次或2剂次水痘疫苗普遍具有成本效益;接种2剂次与1剂次相比,成本效益尚待进一步研究,但随着时间推移,2剂次接种的成本效益正逐渐提高。   结论  应进一步开展2剂次与1剂次水痘疫苗免疫策略成本效益的对比研究。我国应基于国内数据,开展水痘疫苗不同免疫策略经济学研究,从而采用成本效益佳的水痘疫苗免疫策略。     

上海市长宁区≥60岁人群新型冠状病毒疫苗的接种特征及保护效率

【目的】了解上海市长宁区≥60岁人群新型冠状病毒疫苗（简称“新冠疫苗”）的接种特征和疫苗对新冠病毒感染的保护效率（VE），为进一步实施老年人新冠疫苗接种策略提供参考。【方法】收集2020年12月21日—2022年2月28日长宁区≥60岁人群新冠疫苗接种数据和2022年3月1日—2022年5月31日长宁区≥60岁人群新冠病毒感染确诊病例个案数据，采用过筛法对疫苗的VE进行评价。【结果】老年人群中新冠疫苗至少部分免疫、至少全程免疫和加强免疫的接种率分别为69.89%、63.80%和31.91%,80岁及以上老年人疫苗接种率最低。疫苗对重症、危重症或死亡病例的VE最高，全程免疫的VE为96.15%(95%CI:84.15～99.06)，加强免疫的VE达100%。【结论】老年人新冠疫苗全程和加强免疫接种率偏低，特别是≥80岁的老年人。国产新冠疫苗接种对老年人新冠病毒奥密克戎BA.2变异株感染后的重症、危重症或死亡有保护效果。     

子宫颈癌等人乳头瘤病毒相关疾病免疫预防专家共识

人乳头瘤病毒（human papilloma virus, HPV）感染是导致宫颈癌发生的主要病因,其严重危害全球女性的生命健康。HPV疫苗可有效预防HPV感染和降低宫颈癌的发病率,已在世界各国被广泛应用。近年来,许多国家开展了HPV疫苗的经济学评价研究,并着重评价接种HPV疫苗的成本和社会效益。本文通过整理国内外近年来发表的相关文献,对HPV疫苗接种现状及经济学评价研究作一概述,同时阐述数学模型在HPV疫苗经济学评价中的应用,为我国HPV疫苗接种策略的制定和消除宫颈癌提供科学依据。     

重庆市某区新型冠状病毒疫苗接种者对疫苗的认知及影响因素分析

目的 了解重庆市大足区新型冠状病毒疫苗（新冠疫苗）接种者对疫苗的认知及影响因素,为新冠疫苗的科普宣传和健康教育提供参考依据。方法 选择2021年2月4日至3月15日在新冠疫苗接种门诊接种疫苗的人群作为调查对象进行问卷调查,分析调查对象对新冠疫苗认知情况及影响因素、疫苗相关知识获取途径、接种新冠疫苗时关注的因素及为他人推荐意愿。结果 共调查1 800人,回收有效问卷1 549份,有效回收率86.06%。71.21%调查对象对新冠疫苗认知足够（1 103/1 549）。女性（OR=0.693,95%CI:0.541～0.888,P=0.004）、年龄31～40岁（OR=0.544,95%CI:0.370～0.800,P=0.002）、职业为教师（OR=2.804,95%CI:1.060～7.421,P=0.038）、初中及以上文化程度是影响新冠疫苗认知的因素。49.84%调查对象主要通过电视新闻报道获取疫苗相关信息,73.85%认为电视新闻报道的信息可信度最高。调查对象最关注的因素是疫苗安全性（85.67%）和有效性（69.66%）。结论 重庆市大足区新冠疫苗接种者对疫苗的认知水平比较有限...     

推进我国老年人新型冠状病毒疫苗接种的策略分析

【目的】新型冠状病毒疫苗（简称“新冠疫苗”）接种对疫情控制至关重要，我国老年人全程接种和加强接种率较低，亟须加快我国老年人疫苗接种进程。【方法】通过对相关文献和政府网站的梳理，借鉴英国、美国、新加坡和韩国提高老年人接种的政策经验，深入分析我国老年人接种新冠疫苗的现状和原因，从接种重点人群、服务提供及接种意愿3个方面探索提高老年人新冠疫苗接种的策略建议。【结果】实现接种重点人群转变、依靠家庭医生制度建立长久机制、提高接种意愿是推进我国老年人新冠疫苗接种的重要途径。【结论】老年人新冠疫苗接种需要不断强化，现有接种模式应接不暇，应依靠家庭医生制度建立长久机制，从动员模式转变为常态化接种模式。     

b型流感嗜血杆菌疫苗纳入免疫规划的卫生经济学研究系统评价

目的对b型流感嗜血杆菌(Hib)疫苗纳入免疫规划(EPI)的卫生经济学研究文献进行系统评价。方法通过8个中英文文献数据库检索国内外Hib疫苗卫生经济学研究文献,对纳入文献进行信息提取,归纳Hib疫苗经济学研究的方法、设计和研究结果。结果共纳入32篇文献,其中25篇从全社会角度进行研究;26篇的研究对象为5岁或1岁儿童;均采用成本-效果分析(CEA)、成本-效益分析(CBA)和/或成本-效用分析(CUA);均使用静态模型。27篇文献(包括在中国研究的2篇文献)认为Hib疫苗纳入国家免疫规划具有经济学效益,即节约社会成本;5篇文献认为不具有经济学效益。结论本系统评价显示Hib疫苗纳入免疫规划通常具有经济学效益;建议中国针对Hib疫苗纳入国家免疫规划进行高质量的卫生经济学研究。     

青少年和成人百日咳疫苗加强免疫策略卫生经济学研究的系统评价北大核心

目的系统评价青少年和成人百日咳疫苗加强免疫的卫生经济学研究质量和结果。方法通过Pubmed、中国知网等数据库检索2000年1月-2020年1月发表的青少年和成人百日咳疫苗加强免疫卫生经济学研究文献,采用卫生经济研究统一整理评估报告标准(Consolidated health economic evaluation reporting standards,CHEERS)评分(满分24分)评价文献质量,分析卫生经济学评价结果。结果共纳入符合标准的研究文献16篇,均为国外文献,文献的CHEERS评分平均为22.56分(范围:20-24分)。针对青少年或成人百日咳加强免疫策略,8篇研究认为符合成本效果或节约成本(7篇研究人群为青少年),5篇研究认为在一定条件下(如百日咳发病率>50/10万)符合成本效果,3篇研究认为不符合成本效果。结论纳入的研究文献质量较高;经济学评价结果倾向于支持青少年百日咳加强免疫策略,而成人加强免疫策略评价结果差异较大。建议开展中国百日咳免疫策略的卫生经济学研究。     

青少年和成人百日咳疫苗加强免疫策略卫生经济学研究的系统评价

目的系统评价青少年和成人百日咳疫苗加强免疫的卫生经济学研究质量和结果。方法通过Pubmed、中国知网等数据库检索2000年1月-2020年1月发表的青少年和成人百日咳疫苗加强免疫卫生经济学研究文献,采用卫生经济研究统一整理评估报告标准(Consolidated health economic evaluation reporting standards,CHEERS)评分(满分24分)评价文献质量,分析卫生经济学评价结果。结果共纳入符合标准的研究文献16篇,均为国外文献,文献的CHEERS评分平均为22.56分(范围:20-24分)。针对青少年或成人百日咳加强免疫策略,8篇研究认为符合成本效果或节约成本(7篇研究人群为青少年),5篇研究认为在一定条件下(如百日咳发病率50/10万)符合成本效果,3篇研究认为不符合成本效果。结论纳入的研究文献质量较高;经济学评价结果倾向于支持青少年百日咳加强免疫策略,而成人加强免疫策略评价结果差异较大。建议开展中国百日咳免疫策略的卫生经济学研究。     

Assessing the cost-effectiveness of COVID-19 vaccines in a low incidence and low mortality setting: the case of Thailand at start of the pandemic

Objective

This study aimed to assess the cost-effectiveness of COVID-19 vaccines, preferred COVID-19 vaccine profiles, and the preferred vaccination strategies in Thailand.

Methods

An age-structured transmission dynamic model was developed based on key local data to evaluate economic consequences, including cost and health outcome in terms of life-years (LYs) saved. We considered COVID-19 vaccines with different profiles and different vaccination strategies such as vaccinating elderly age groups (over 65s) or high-incidence groups, i.e. adults between 20 and 39 years old who have contributed to more than 60% of total COVID-19 cases in the country thus far. Analyses employed a societal perspective in a 1-year time horizon using a cost-effectiveness threshold of 160,000 THB per LY saved. Deterministic and probabilistic sensitivity analyses were performed to identify and characterize uncertainty in the model.

Results

COVID-19 vaccines that block infection combined with social distancing were cost-saving regardless of the target population compared to social distancing alone (with no vaccination). For vaccines that block infection, the preferred (cost-effective) strategy was to vaccinate the high incidence group. Meanwhile, COVID-19 vaccines that reduces severity (including hospitalization and mortality) were cost-effective when the elderly were vaccinated, while vaccinating the high-incidence group was not cost-effective with this vaccine type. Regardless of vaccine type, higher vaccination coverage, higher efficacy, and longer protection duration were always preferred. More so, vaccination with social distancing measures was always preferred to strategies without social distancing. Quarantine-related costs were a major cost component affecting the cost-effectiveness of COVID-19 vaccines.

Conclusion

COVID-19 vaccines are good value for money even in a relatively low-incidence and low-mortality setting such as Thailand, if the appropriate groups are vaccinated. The preferred vaccination strategies depend on the type of vaccine efficacy. Social distancing measures should accompany a vaccination strategy.

     

新型冠状病毒肺炎非药物干预防控措施经济学评价研究进展

目的了解国内外新型冠状病毒肺炎非药物干预(non-pharmaceutical interventions, NPIs)措施的经济评价研究进展, 为开展基于中国真实世界证据的NPIs措施经济学评价提供参考。方法对中英文数据库2020年1月至2021年12月的文献进行检索, 纳入NPIs措施以及不同NPIs措施组合的经济学评价文献, 并对相关文献进行叙述性整合。结果本研究共纳入30篇中英文文献, 其中以核酸合并抗原检测/筛查类策略为主的研究7篇, 以个人防护类策略为主的研究6篇, 个人防护、保持社交隔离、核酸检测、抗原检测/筛查、社区大规模筛查、症状筛查、密切接触者(密接)追踪、隔离组合策略研究12篇, 封锁等抑制策略为主的研究5篇。研究发现个人防护、社交距离和筛查-密接追踪-隔离具有成本效果/效用/效益, 但不同的组合方式会导致不同结果, 此外, 封锁成本较高会带来较重的经济负担。结论除封锁外的NPIs措施大多具有成本效果, 不同情境下不同程度NPIs措施组合的成本效果需要再评估。亟需开展基于我国真实世界的NPIs措施组合以及NPIs措施与疫苗、药物等其他干预组合的经济学评价研究。     

Reasons for COVID-19 Vaccine Hesitancy Among Chinese People Living With HIV/AIDS: Structural Equation Modeling Analysis

BackgroundMany countries and organizations recommended people living with HIV/AIDS (PLWHA) receive the COVID-19 vaccine. However, vaccine hesitancy still exists and becomes a barrier for promoting COVID-19 vaccination among PLWHA.ObjectiveThis study aims to investigate factors that contributed to COVID-19 vaccine hesitancy among PLWHA.MethodsThe study used a multicenter cross-sectional design and an online survey mode. We recruited PLWHA aged 18-65 years from 5 metropolitan cities in China between January 2021 and February 2021. Participants completed an online survey through Golden Data, a widely used encrypted web-based survey platform. Multiple linear regression models were used to assess the background characteristics in relation to COVID-19 vaccine hesitancy, and structural equation modeling was performed to assess the relationships among perceived benefits, perceived risks, self-efficacy, subjective norms, and COVID-19 vaccine hesitancy.ResultsAmong 1735 participants, 41.61% (722/1735) reported COVID-19 vaccine hesitancy. Older age, no other vaccinations in the past 3 years, and having chronic disease history were positively associated with COVID-19 vaccine hesitancy. Structural equation modeling revealed a direct relationship of perceived benefits, perceived risks, and subjective norms with self-efficacy and vaccine hesitancy and an indirect relationship of perceived benefits, perceived risks, and subjective norms with vaccine hesitancy. Moreover, self-efficacy toward COVID-19 vaccination was low. PLWHA had concerns of HIV disclosure during COVID-19 vaccination. Family member support could have an impact on COVID-19 vaccination decision-making.ConclusionsCOVID-19 vaccine hesitancy was high among PLWHA in China. To reduce COVID-19 vaccine hesitancy, programs and strategies should be adopted to eliminate the concerns for COVID-19 vaccination, disseminate accurate information on the safety and efficacy of the COVID-19 vaccine, encourage family member support for COVID-19 vaccination, and improve PLWHA’s trust of medical professionals.     

Individual preferences for COVID-19 vaccination in China

BackgroundVaccinations are an effective choice to stop disease outbreaks, including COVID-19. There is little research on individuals' COVID-19 vaccination decision-making.ObjectiveWe aimed to determine individual preferences for COVID-19 vaccinations in China, and to assess the factors influencing vaccination decision-making to facilitate vaccination coverage.MethodsA D-efficient discrete choice experiment was conducted across six Chinese provinces selected by the stratified random sampling method. Vaccine choice sets were constructed using seven attributes: vaccine effectiveness, side-effects, accessibility, number of doses, vaccination sites, duration of vaccine protection, and proportion of acquaintances vaccinated. Conditional logit and latent class models were used to identify preferences.ResultsAlthough all seven attributes were proved to significantly influence respondents’ vaccination decision, vaccine effectiveness, side-effects and proportion of acquaintances vaccinated were the most important. We also found a higher probability of vaccinating when the vaccine was more effective; risks of serious side effects were small; vaccinations were free and voluntary; the fewer the number of doses; the longer the protection duration; and the higher the proportion of acquaintances vaccinated. Higher local vaccine coverage created altruistic herd incentives to vaccinate rather than free-rider problems. The predicted vaccination uptake of the optimal vaccination scenario in our study was 84.77%. Preference heterogeneity was substantial. Individuals who were older, had a lower education level, lower income, higher trust in the vaccine and higher perceived risk of infection, displayed a higher probability to vaccinate.ConclusionsPreference heterogeneity among individuals should lead health authorities to address the diversity of expectations about COVID-19 vaccinations. To maximize COVID-19 vaccine uptake, health authorities should promote vaccine effectiveness; pro-actively communicate the absence or presence of vaccine side effects; and ensure rapid and wide media communication about local vaccine coverage.     

Examining the Utility of Social Media in COVID-19 Vaccination: Unsupervised Learning of 672,133 Twitter Posts

BackgroundAlthough COVID-19 vaccines have recently become available, efforts in global mass vaccination can be hampered by the widespread issue of vaccine hesitancy.ObjectiveThe aim of this study was to use social media data to capture close-to-real-time public perspectives and sentiments regarding COVID-19 vaccines, with the intention to understand the key issues that have captured public attention, as well as the barriers and facilitators to successful COVID-19 vaccination.MethodsTwitter was searched for tweets related to “COVID-19” and “vaccine” over an 11-week period after November 18, 2020, following a press release regarding the first effective vaccine. An unsupervised machine learning approach (ie, structural topic modeling) was used to identify topics from tweets, with each topic further grouped into themes using manually conducted thematic analysis as well as guided by the theoretical framework of the COM-B (capability, opportunity, and motivation components of behavior) model. Sentiment analysis of the tweets was also performed using the rule-based machine learning model VADER (Valence Aware Dictionary and Sentiment Reasoner).ResultsTweets related to COVID-19 vaccines were posted by individuals around the world (N=672,133). Six overarching themes were identified: (1) emotional reactions related to COVID-19 vaccines (19.3%), (2) public concerns related to COVID-19 vaccines (19.6%), (3) discussions about news items related to COVID-19 vaccines (13.3%), (4) public health communications about COVID-19 vaccines (10.3%), (5) discussions about approaches to COVID-19 vaccination drives (17.1%), and (6) discussions about the distribution of COVID-19 vaccines (20.3%). Tweets with negative sentiments largely fell within the themes of emotional reactions and public concerns related to COVID-19 vaccines. Tweets related to facilitators of vaccination showed temporal variations over time, while tweets related to barriers remained largely constant throughout the study period.ConclusionsThe findings from this study may facilitate the formulation of comprehensive strategies to improve COVID-19 vaccine uptake; they highlight the key processes that require attention in the planning of COVID-19 vaccination and provide feedback on evolving barriers and facilitators in ongoing vaccination drives to allow for further policy tweaks. The findings also illustrate three key roles of social media in COVID-19 vaccination, as follows: surveillance and monitoring, a communication platform, and evaluation of government responses.     

Reminders of existing vaccine mandates increase support for a COVID-19 vaccine mandate: Evidence from a survey experiment

BackgroundGovernments are trying various strategies to boost COVID-19 vaccination rates, including vaccine mandates. Popular support for such mandates, however, is in flux in many countries, including the United States. The objective of this study is to evaluate if the wording of public health messages could increase popular support for COVID-19 vaccine mandates.MethodsWe conducted a survey experiment on a sample of 573 registered voters in South Dakota, United States. Participants in the control group (n = 271) read a short message about mandatory COVID-19 vaccination. Respondents in the treatment group (n = 278) read the same message but they were reminded that a variety of vaccine mandates for measles, mumps, rubella, and polio have long been required. Afterwards, both groups were asked about their support for COVID-19 vaccine mandate.ResultsA multivariate ordinary least squares regression analysis revealed that the experimental treatment had a positive and statistically significant impact on support for mandatory COVID-19 vaccination (p < 0.001). We also found that COVID-19 vaccination status, religious identity, and political affiliation have a statistically significant effect.ConclusionsOur findings suggest that a simple intervention—reminding the public of the existing vaccine mandates—increases support for COVID-19 vaccine mandate. Public health authorities who seek to boost COVID-19 vaccination rates could utilize this approach.     

Vaccination willingness,vaccine hesitancy,and estimated coverage at the first round of COVID-19 vaccination in China: A national cross-sectional study

BackgroundVaccination against coronavirus disease 2019 (COVID-19) has become an important public health solution. To date, there has been a lack of data on COVID-19 vaccination willingness, vaccine hesitancy, and vaccination coverage in China since the vaccine has become available.MethodsWe designed and implemented a cross-sectional, population-based online survey to evaluate the willingness, hesitancy, and coverage of the COVID-19 vaccine among the Chinese population. 8742 valid samples were recruited and classified as the vaccine-priority group (n = 3902; 44.6%) and the non-priority group (n = 4840; 55.4%).ResultsThe proportion of people’s trust in the vaccine, delivery system, and government were 69.0%, 78.0% and 81.3%, respectively. 67.1% of the participants were reportedly willing to accept the COVID-19 vaccination, while 9.0% refused it. 834 (35.5%) reported vaccine hesitancy, including acceptors with doubts (48.8%), refusers (39.4%), and delayers (11.8%). The current coverage was 34.4%, far from reaching the requirements of herd immunity. The predicted rate of COVID-19 vaccination was 64.9%, 68.9% and 81.1% based on the rates of vaccine hesitancy, willingness, and refusal, respectively.ConclusionsThe COVID-19 vaccine rate is far from reaching the requirements of herd immunity, which will require more flexible and comprehensive efforts to improve the population’s confidence and willingness to vaccinate. It should be highlighted that vaccination alone is insufficient to stop the pandemic; further efforts are needed not only to increase vaccination coverage but also to maintain non-specific prevention strategies.     

Changes in Parental Attitudes Toward COVID-19 Vaccination and Routine Childhood Vaccination During the COVID-19 Pandemic: Repeated Cross-sectional Survey Study

BackgroundIt was reported that one in four parents were hesitant about vaccinating their children in China. Previous studies have revealed a declining trend in the vaccine willingness rate in China. There is a need to monitor the level of parental vaccine hesitancy toward routine childhood vaccination and hesitancy toward the COVID-19 vaccine during the ongoing COVID-19 pandemic.ObjectiveThis study aims to assess changes in trends of parental attitudes toward routine childhood vaccines and COVID-19 vaccinations across different time periods in China.MethodsThree waves of cross-sectional surveys were conducted on parents residing in Wuxi City in Jiangsu Province, China from September to October 2020, February to March 2021, and May to June 2021. Participants were recruited from immunization clinics. Chi-square tests were used to compare the results of the three surveys, controlling for sociodemographic factors. Binary and multivariable logistic regression analysis was used to examine factors related to parental vaccine hesitancy and COVID-19 vaccine willingness.ResultsOverall, 2881, 1038, and 1183 participants were included in the survey’s three waves. Using the Vaccine Hesitancy Scale, 7.8% (225/2881), 15.1% (157/1038), and 5.5% (65/1183) of parents showed hesitancy to childhood vaccination (P<.001), and 59.3% (1709/2881), 64.6% (671/1038), and 92% (1088/1183) of parents agreed to receive a COVID-19 vaccine themselves in the first, second, and third surveys, respectively (P<.001). In all three surveys, “concerns about vaccine safety and side effects” was the most common reason for refusal.ConclusionsThere has been an increasing acceptance of COVID-19 vaccination in Wuxi City, China. Effective interventions are needed to mitigate public concerns about vaccine safety.     

Parental attitudes in the pediatric emergency department about the COVID-19 vaccine

BackgroundCOVID-19 vaccinations are now recommended in the United States (U.S.) for children ≥ 6 months old. However, pediatric vaccination rates remain low, particularly in the Hispanic/Latinx population.ObjectiveUsing the 4C vaccine hesitancy framework (calculation, complacency, confidence, convenience), we examined parental attitudes in the emergency department (ED) towards COVID-19 vaccination, identified dimensions of parental vaccine hesitancy, and assessed parental willingness to have their child receive the COVID-19 vaccine.MethodsAs part of a larger multi-methods study examining influenza vaccine hesitancy, we conducted interviews that included questions about COVID-19 vaccine authorization for children. We used directed content analysis to extract qualitative themes from 3 groups of parents in the ED: Hispanic/Latinx Spanish speaking (HS), Hispanic/Latinx English speaking (HE), non-Hispanic/non-Latinx White English speaking (WE). Themes were triangulated with the Parent Attitudes about Childhood Vaccines (PACV) survey, where higher scores indicate increased vaccine hesitancy.ResultsFactors influencing vaccine hesitancy were mapped to the 4C framework from 58 sets of interviews and PACVs. HE and HS parents, compared to WE parents, had less knowledge about COVID-19 and its vaccine, and more beliefs in COVID-19 vaccine myths. However, both HS and HE parent groups were more inclined to endorse COVID-19 vaccine effectiveness as a reason to have their children vaccinated. HS parents felt that COVID-19 increased their fear of illnesses in general and were worried about confusing COVID-19 with other infections. Median PACV scores of HS (Mdn = 20) and HE (Mdn = 20) parent groups were higher than of WE parents (Mdn = 10), but parental willingness to have their child receive COVID-19 vaccination was similar across groups.ConclusionsHigher COVID-19 vaccine hesitancy among HS and HE parents compared to WE parents may be attributed to insufficient knowledge about COVID-19, its vaccine, along with COVID-19 vaccine myths. Efforts to provide targeted vaccine education to different populations is warranted.