Factors Associated With COVID-19 Non-vaccination in Adolescents Hospitalized Without COVID-19
BACKGROUND: Pfizer-BioNTech COVID-19 vaccine received emergency use authorization for persons ≥ 16 years in December 2020 and for adolescents 12-15 years in May 2021. Despite the clear benefits and favorable safety profile, vaccine uptake in adolescents has been suboptimal. We sought to assess factors associated with COVID-19 non-vaccination in adolescents 12-18 years of age. METHODS: Between June 1, 2021 and April 29, 2022, we assessed factors associated with COVID-19 non-vaccination in hospitalized adolescents ages 12-18 years enrolled in the Overcoming COVID-19 vaccine effectiveness network. Demographic characteristics and clinical information were captured through parent interviews and/or electronic medical record abstraction; COVID-19 vaccination was assessed through documented sources. We assessed associations between receipt of the COVID-19 vaccine and demographic and clinical factors using univariate and multivariable logistic regression and estimated adjusted odds ratios (aOR) for each factor associated with non-vaccination. RESULTS: Among 1665 hospitalized adolescents without COVID-19, 56% were unvaccinated. Unvaccinated adolescents were younger (median age 15.1 years vs. 15.4 years, p < .01) and resided in areas with higher social vulnerability index (SVI) scores (median 0.6 vs 0.5, p < .001) than vaccinated adolescents. Residence in the Midwest [aOR 2.60 (95% CI: 1.80, 3.79)] or South [aOR 2.49 (95% CI: 1.77, 3.54)] US census regions, rarely or never receiving influenza vaccine [aOR 5.31 (95% CI: 3.81, 7.47)], and rarely or never taking precautions against COVID-19 [aOR 3.17 (95% CI: 1.94, 5.31)] were associated with non-vaccination against COVID-19. CONCLUSIONS: Efforts to increase COVID-19 vaccination of adolescents should focus on persons with geographic, socioeconomic, and medical risk factors associated with non-vaccination.
Authors
- Satoshi Kamidani (ORCID: https://orcid.org/0000-0001-6829-0700)
- Jennifer E. Schuster
- Janet R. Hume (ORCID: https://orcid.org/0000-0002-8891-6800)
- Emily R. Levy (ORCID: https://orcid.org/0000-0001-8447-7663)
- Mary Glas Gaspers (ORCID: https://orcid.org/0000-0003-0561-9411)
- Margaret M. Newhams (ORCID: https://orcid.org/0000-0002-3738-1172)
- Bria M. Coates (ORCID: https://orcid.org/0000-0003-4264-5440)
- Tamara T. Bradford (ORCID: https://orcid.org/0000-0001-5220-7423)
- Katherine Irby (ORCID: https://orcid.org/0000-0001-8111-3215)
- Ryan A. Nofziger (ORCID: https://orcid.org/0000-0001-7057-2686)
- Charlotte V. Hobbs (ORCID: https://orcid.org/0000-0003-4829-0791)
- Natalie Z. Cvijanovich (ORCID: https://orcid.org/0000-0001-9905-4137)
- Natasha Halasa (ORCID: https://orcid.org/0000-0002-6381-1826)
- Kathleen Chiotos (ORCID: https://orcid.org/0000-0002-0204-8708)
- Samina S. Bhumbra (ORCID: https://orcid.org/0000-0002-4036-0479)
- Ashley M Price (ORCID: https://orcid.org/0000-0002-1480-2843)
- Melissa L. Cullimore (ORCID: https://orcid.org/0000-0002-9150-9923)
- Julie A. Boom (ORCID: https://orcid.org/0000-0002-5500-117X)
- Aline B. Maddux (ORCID: https://orcid.org/0000-0002-0949-4284)
- Melissa A. Cameron (ORCID: https://orcid.org/0000-0003-3710-0809)
- Brandon Chatani (ORCID: https://orcid.org/0000-0002-6584-7048)
- Mia Maamari (ORCID: https://orcid.org/0000-0002-0118-1638)
- Mary Allen Staat (ORCID: https://orcid.org/0000-0003-1788-8037)
- Stephanie P. Schwartz (ORCID: https://orcid.org/0000-0003-4314-6117)
- Laura Smallcomb (ORCID: https://orcid.org/0000-0002-2372-6790)
- Shira J. Gertz (ORCID: https://orcid.org/0000-0001-8119-6006)
- Matt S. Zinter (ORCID: https://orcid.org/0000-0003-3351-3278)
- Tracie C. Walker (ORCID: https://orcid.org/0000-0002-6077-2315)
- Heidi R. Flori (ORCID: https://orcid.org/0000-0002-6047-6970)
- Adrienne G. Randolph (ORCID: https://orcid.org/0000-0002-3084-3071)
- Sabrina M. Heidemann (ORCID: https://orcid.org/0000-0002-4071-0280)
- Elizabeth H. Mack (ORCID: https://orcid.org/0000-0002-6913-6892)
- Pia S. Pannaraj (ORCID: https://orcid.org/0000-0002-5208-0933)
- Michele Kong (ORCID: https://orcid.org/0000-0001-6596-3965)
- Samantha M. Olson (ORCID: https://orcid.org/0000-0003-0589-5766)
- Leila C. Sahni (ORCID: https://orcid.org/0000-0002-0833-5695)
- Katherine Bline (ORCID: https://orcid.org/0000-0002-2399-8075)
- Keiko M. Tarquinio (ORCID: https://orcid.org/0000-0003-2688-1021)
- Manish Patel (ORCID: https://orcid.org/0000-0002-9407-8647)
Institutions
- University of North Carolina at Chapel Hill (US)
Publication Details
- Journal
- UNC Libraries
- Published
- 2025-04-16
- DOI
- https://doi.org/10.17615/35ay-g766
- Primary Topic
- Vaccine Coverage and Hesitancy
- Type
- article
- Field-Weighted Citation Impact
- 0.00