Social inequalities in COVID-19 vaccine acceptance and uptake for children and adolescents in Montreal,Canada |
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| Institution: | 1. Centre for Public Health Research, University of Montreal, Pavillon 7101 avenue du Parc, Montreal, Quebec H3C 3J7, Canada;2. Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada;3. Department of Microbiology, Infectious Diseases, and Immunology, University of Montreal, Pavillon Roger-Gaudry, 2900 boul. Édouard-Montpetit, Montréal, Québec H3T 1J4, Canada;4. Centre de recherche du CHU de Québec, Laval University, 2705, boulevard Laurier Quebec, Quebec G1V 4G2, Canada;5. Direction régionale de la santé publique de Montréal du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, 155 boulevard Saint-Joseph Est, Montréal, Quebec H2T 1H4, Canada;6. School of Public Health, University of Montreal, Pavillon 7101 avenue du Parc, Montreal, Quebec H3C 3J7, Canada |
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| Abstract: | BackgroundThe success of current and prospective COVID-19 vaccine campaigns for children and adolescents will in part depend on the willingness of parents to accept vaccination. This study examined social determinants of parental COVID-19 vaccine acceptance and uptake for children and adolescents.MethodsWe used cross-sectional data from an ongoing COVID-19 cohort study in Montreal, Canada and included all parents of 2 to 18-year-olds who completed an online questionnaire between May 18 and June 26, 2021 (n = 809). We calculated child age-adjusted prevalence estimates of vaccine acceptance by parental education, race/ethnicity, birthplace, household income, and neighbourhood, and used multinomial logistic regression to estimate adjusted prevalence differences (aPD) and ratios (aPR). Social determinants of vaccine uptake were examined for the vaccine-eligible sample of 12 to 18 year-olds (n = 306).ResultsIntention to vaccinate children against COVID-19 was high, with only 12.4% of parents unlikely to have their child vaccinated. Parents with younger children were less likely to accept vaccination, as were those from lower-income households, racialized groups, and those born outside Canada. Children from households with annual incomes <$100,000 had 18.4 percent lower prevalence of being vaccinated/very likely vaccinated compared to household incomes ≥$150,000 (95% CI: 10.1 to 26.7). Racialized parents reported greater unwillingness to vaccinate vs. White parents (aPD = 10.3; 95% CI: 1.5, 19.1). Vaccine-eligible adolescents from the most deprived neighbourhood were half as likely to be vaccinated compared to those from the least deprived neighbourhood (aPR = 0.48; 95% CI: 0.18 to 0.77).Interpretation.This study identified marked social inequalities in COVID-19 vaccine acceptance and uptake for children and adolescents. Efforts are needed to reach disadvantaged and marginalized populations with tailored strategies that promote informed decision making and facilitate access to vaccination. |
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| Keywords: | COVID-19 Child health Social inequalities Vaccination |
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