COVID-19 Vaccine Uptake Inequality Among Children: A Multidimensional Demographic Analysis

<b>Background:</b> Although children can contract COVID-19, their typically lower immune reactivity appears to shield them from the intense hyperinflammatory response observed in other age groups, leading to milder disease symptoms. Nonetheless, children's infection raises the possibility of unwanted transmission of the coronavirus to others, especially because most infected children are asymptomatic. <b>Objectives:</b> This study examines the uptake of the first and second doses of the COVID-19 vaccine among children by combinations of age, race, ethnicity, and sex. <b>Methods:</b> Data from the immunization registry were utilized to assess changes over time in COVID-19 vaccine uptake among children in Jefferson County, Kentucky's most populous county. The analysis examined trends by age, race, ethnicity, and combinations of age-race, age-ethnicity, age-race-sex, and age-ethnicity-sex during the first six quarters of the COVID-19 vaccination rollout. <b>Results:</b> By May 2022, in 16-17-year-olds, the highest and lowest COVID-19 vaccination rates were observed among White and Black children (64.8% versus 41.2%, respectively, for dose two). The highest two-dose vaccination rate at ages 12-15 years was among Multiracial and White children (63.3% and 62.9%, respectively), the lowest among Black children (38.8%). The highest two-dose vaccination rate at ages 5-11 years was among children of Some Other Races, Asian, and White children (37.0%, 36.7%, and 35.5%, respectively), and the lowest among Black children (17.2%). <b>Conclusions:</b> Inequalities in COVID-19 vaccination based on race, ethnicity, and sex persisted throughout the study period. Efforts in vaccine distribution and promotional initiatives should focus on increasing vaccination rates among children from racial and ethnic minority groups and males.