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Children and COVID-19 Research Library

UNICEF Innocenti's curated library of COVID-19 + Children research

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Parental COVID-19 vaccine hesitancy: a cross-sectional survey in Italy

Aida Bianco; Giorgia Della Polla; Silvia Angelillo (et al.)

Published: January 2022   Journal: Expert Review of Vaccines

Understanding parents’ hesitancy against COVID-19 vaccination for their children is useful. A self-administered online survey was conducted among 394 parents with at least one child aged 12–18 years in Italy.

Impact of the COVID-19 pandemic on pediatric and adolescent vaccinations and well child visits in the United States: a database analysis

Stephanie A. Kujawski; Lixia Yao; H. Echo Wang (et al.)

Published: January 2022   Journal: Vaccine

The COVID-19 pandemic has disrupted healthcare, including immunization practice and well child visit attendance. Maintaining vaccination coverage is important to prevent disease outbreaks and morbidity. This study assessed the impact of the COVID-19 pandemic on pediatric and adolescent vaccination administration and well child visit attendance in the United States. This cross-sectional study used IBM MarketScan Commercial Database (IMC) with Early View (healthcare claims database) and TriNetX Dataworks Global Network (electronic medical records database) from January 2018–March 2021.

The little jab book: a playbook for COVID-19 vaccination in Nepal
Institution: Save the Children
Published: January 2022

Inspired by The Little Jab Book, this playbook uncovers underlying reasons for vaccine hesitancy in Nepal and includes localized, behavioral science-informed solutions to increase uptake of COVID-19 vaccines. The Busara Center for Behavioral Economics, Common Thread, Save the Children Nepal, and Save the Children’s Center for Utilizing Behavioral Insights for Children (CUBIC) collaborated to conduct quantitative and qualitative research in Province 2 to uncover barriers and enablers to vaccination, and then co-created potential solutions with local and national stakeholders; this research project resulted in 9 behavioral science interventions for parents and health workers in Nepal.

Early experience of COVID-19 vaccine-related adverse events among adolescents and young adults with rheumatic diseases: a single-center study

Fatih Haslak; Aybuke Gunalp; Memnune Nur Cebi (et al.)

Published: January 2022   Journal: International Journal of Rheumatic Diseases

Considering the concerns regarding the coronavirus disease-2019 (COVID-19) vaccine safety among pediatric patients with inflammatory rheumatic diseases (IRD) due to a lack of data, an urgent need for studies evaluating safety profiles of vaccines emerged. Among participants vaccinated by CoronaVac inactive SARS-CoV-2 or BNT162b2 messenger RNA (mRNA) COVID-19 (Pfizer-BioNTech) vaccine, healthy children under 18 and patients under 21 with an at least 1-year follow-up period in our department for a childhood-onset rheumatic disease were included into this cross-sectional study.

Scaling the children immunization app (CIMA) to support child refugees and parents in the time of the COVID-19 pandemic: a social capital approach to scale a smartphone application in Zaatari Camp, Jordan

Yousef S. Khader; Wadih Maalouf; Mohammad Abu Khdair (et al.)

Published: January 2022   Journal: Journal of Epidemiology and Global Health

Children vaccination is a key intervention for their survival, especially among refugees. Yet, children vaccination registration is done manually in refugees camps and there is no possibility to send reminders to parents to come back on time. This study aimed to boost the parental registration of children’s vaccination records on a Children Immunization app (CIMA) while also availing the parents with useful parenting skills under COVID-19-related stress. It incorporated United Nations Office on Drugs and Crime (UNODC) Parenting Skills under COVID-19 information material, through CIMA in Arabic and English languages. 1100 children were recruited in February–March 2021, through a community health promotion dissemination approach. A team of two nurses from the local population and two volunteers (one trained nurse and one trained social worker), from the camp, was formed. They promoted the CIMA app at two clinics and through households visits in Zaatari refugee camp. Qualitative data on impressions and observations of the interactions with the Zaatari camp community were also collected.

The thoughts of parents to vaccinate their children against COVID-19: an assessment of situations that may affect them

Melike Y. Çelik

Published: December 2021   Journal: Journal of Child and Adolescent Psychiatric Nursing

This study examined what affects parents' thoughts about vaccinating their children. It explored whether parents' attitudes towards the coronavirus disease 2019 (COVID-19) vaccine and their perception of control of COVID-19 were related to their thoughts about vaccinating their children. The sample of this descriptive study consisted of parents (n = 274) with children between the ages of 0–12. To collect data on parents’ thoughts and opinions participants completed the Attitudes Towards COVID-19 Vaccine Scale and the Perception of Control of COVID-19 Scale.

Parents’ willingness to vaccinate their children against seasonal influenza after the COVID-19 pandemic in Saudi Arabia: a retrospective cross-sectional survey

Emad Salawati; Hassan Alwafi; Mohammed Samannodi (et al.)

Published: December 2021   Journal: Patient Preference and Adherence
This paper aims to explore the impact of the novel coronavirus (COVID-19) pandemic on caregivers’ willingness to vaccinate their children against influenza in 2021 in Saudi Arabia and the factors influencing this decision. An online survey of 2501 caregivers in Saudi Arabia with children aged 6 months– 18 years was conducted between July 15, 2021, and August 2, 2021. A convenience sample of participants that met the inclusion criteria was used as the study sample. Social Science Package Statistical (SPSS) was used for the statistical analysis. Categorical variables were reported as frequencies and percentages. The Chi-square test was used for categorical variables to assess the difference between the variables and the parents’ willingness to vaccinate their children against seasonal influenza after the COVID-19 pandemic.
Students’ age and parental level of education influence COVID-19 vaccination hesitancy

Anna Zychlinsky Scharff; Mira Paulsen; Paula Schaefer (et al.)

Published: December 2021   Journal: European Journal of Pediatrics
Widespread vaccination in pursuit of herd immunity has been recognized as the most promising approach to ending the global pandemic of coronavirus disease 19 (COVID-19). The vaccination of children and adolescents has been extensively debated and the first COVID-19 vaccine is now approved in European countries for children aged > 12 years of age. This study investigates vaccination hesitancy in a cohort of German secondary school students. It assessed 903 students between age 9 and 20 in the period between 17 May 2021 and 30 June 2021. 68.3% (n = 617) reported intention to undergo COVID-19 vaccination, while 7% (n = 62) did not want to receive the vaccine and 15% (n = 135) were not yet certain. Age and parental level of education influenced COVID-19 vaccine hesitancy. Children under the age of 16 as well as students whose parents had lower education levels showed significantly higher vaccine hesitancy.
COVID-19 and routine childhood and adolescent immunizations: evidence from Louisiana medicaid

Brigham Walker; Andrew Anderson; Charles Stoecker (et al.)

Published: December 2021   Journal: Vaccine
The COVID-19 pandemic disrupted routine vaccinations for children and adolescents. However, it remains unclear whether the impact has been different for children and adolescents from low-income families. To address this, this study compared monthly routine vaccination use per 1,000 vaccine-eligible children and adolescents enrolled in Louisiana Medicaid in the years before (2017-2019) and during the COVID-19 pandemic (2020). Compared to the 2017-2019 average vaccination rates, it found a 28% reduction in measles, mumps, and rubella (MMR), a 35% reduction in human papillomavirus (HPV), and a 30% reduction in tetanus, diphtheria, pertussis (Tdap) vaccinations in 2020. Vaccine uptake was lower in April 2020 after the declaration of a state of emergency and in late summer when back-to-school vaccinations ordinarily occur.
Chinese parents’ intentions to vaccinate their children against SARS-CoV-2 infection and vaccine preferences

Yulan Lin; Zhijian Hu; Qinjian Zhao (et al.)

Published: December 2021   Journal: Human Vaccines & Immunotherapeutics
This study aims to determine the intention of Chinese parents to vaccinate their children against SARS-CoV-2. Secondly, preferences for foreign- or domestically made COVID-19 vaccines were also explored. A nationwide, cross-sectional, self-administered online survey based on the Health Belief Model (HBM) and new vaccine concerns was used. Participants were eligible if they were residents of China with children aged 12 years old or younger. A total of 2,026 parents responded to the survey. Half reported a probable intent (50.7%) and 26.9% reported a definite intent. The results of the data analysis of partial least squares structural equation modeling (PLS-SEM) found that perceived cost barriers (B = −0.210, p < .001) and new vaccine concerns (B = −0.201, p < .001) had major effects in vaccination intent. Important constructs of vaccine concerns that predict vaccination intent were efficacy (B = 0.898, p < .001), followed by safety (B = 0.861, p < .001), side-effect (B = 0.806, p < .001) and faulty/fake vaccine (B = 0.579, p < .001).
Acceptance of childhood and adolescent vaccination against COVID-19 in France: a national cross-sectional study in May 2021

Pierre Verger; Patrick Peretti-Watel; Amandine Gagneux-Brunon (et al.)

Published: December 2021   Journal: Human Vaccines & Immunotherapeutics
The French health authorities extended vaccination against COVID-19 to adolescents in June 2021, during the epidemic resurgence linked to the delta variant and because of insufficient vaccination coverage to ensure collective protection. In May 2021, a national online cross-sectional survey of 2533 adults was conducted in France to study their attitudes toward COVID-19 vaccines and their acceptance of child/adolescent vaccination according to targeted age groups (<6 years; 6–11; 12–17) and its determinants. This study applied a multi-model averaged logistic regression for each of these age groups to study the determinants of favorability to vaccination. Among the respondents, 62.7% (1597) accepted COVID-19 vaccination for adolescents, 48.3% (1223) for children aged 6–11 years, and only 31% (783) for children under 6 years.
Decline in uptake of childhood vaccinations in a tertiary hospital in Northern Ghana during the COVID-19 pandemic

Kingsley Appiah Bimpong; Benjamin Demah Nuertey; Anwar Sadat Seidu (et al.)

Published: December 2021   Journal: BioMed Research International
At the beginning of the COVID-19 pandemic, early modelling studies estimated a reduction in childhood vaccinations in low- and middle-income countries. Regular provision of both curative and preventive services such as antenatal care and childhood immunizations has been negatively affected since the onset of the pandemic. This study was aimed at examining the impact that the pandemic had on childhood vaccination services at the Tamale Teaching Hospital (TTH). A mixed methods study design was employed for the study, which was conducted at the Child Welfare Clinic (CWC) of the TTH.
Guardians’ willingness to vaccinate their teenagers against COVID-19 in China: a national cross-sectional survey

Jian Wu; Lipei Zhao; Meiyun Wang (et al.)

Published: December 2021   Journal: Journal of Affective Disorders

To investigate Chinese guardians’ willingness to vaccinate teenagers (WVT) against COVID-19, this study conducted a national wide survey in 31 provinces in mainland China. It involved 16133 guardians from 31 provinces in Chinese Mainland from August 6th to 9th, 2021. The question “Are you willing to vaccinate teenagers of COVID-19 vaccine?” was designed to capture WVT. Odds ratios (OR) with 95% Confidence Intervals (CI) for potential factors of WVT were estimated using multiple logistic regression models.

Worldwide beliefs among pregnant women on SARS-CoV-2 vaccine: a systematic review

Luigi Carbone; Raffaella Di Girolamo; Ilenia Mappa (et al.)

Published: December 2021   Journal: European Journal of Obstetrics & Gynecology and Reproductive Biology

SARS-CoV-2 vaccine has been recommended to pregnant women, but survey studies showed contrasting findings worldwide in relation to the willingness to accept vaccination during pregnancy. This study aimed to evaluate the evidence from the literature regarding the acceptance rate of the SARS-CoV-2 vaccine in pregnant and breastfeeding women. It performed a systematic review on the main databases (MEDLINE (PubMed), Scopus, ISI Web of Science) searching for all the peer-reviewed survey studies analyzing the eventual acceptance rate of the SARS-CoV-2 vaccine among pregnant and breastfeeding women. To combine data meta-analyses of proportions and pooled proportions with their 95% confidence intervals (CI) were calculated.

Misinformation warnings: Twitter’s soft moderation effects on COVID-19 vaccine belief echoes

Filipo Sharevski; Raniem Alsaadi; Peter Jachim (et al.)

Published: December 2021   Journal: Computers & Security
Twitter, prompted by the rapid spread of alternative narratives, started actively warning users about the spread of COVID-19 misinformation. This form of soft moderation comes in two forms: as an interstitial cover before the Tweet is displayed to the user or as a contextual tag displayed below the Tweet. This is a 319-participants study with both verified and misleading Tweets covered or tagged with the COVID-19 misinformation warnings to investigate how Twitter users perceive the accuracy of COVID-19 vaccine content on Twitter. The results suggest that the interstitial covers work, but not the contextual tags, in reducing the perceived accuracy of COVID-19 misinformation.
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UNICEF Innocenti's Children and COVID-19 Library is a database collecting research from around the world on COVID-19 and its impacts on children and adolescents.


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UNICEF Innocenti is mobilizing a rapid research response in line with UNICEF’s global response to the COVID-19 crisis. The initiatives we’ve begun will provide the broad range of evidence needed to inform our work to scale up rapid assessment, develop urgent mitigating strategies in programming and advocacy, and preparation of interventions to respond to the medium and longer-term consequences of the COVID-19 crisis. The research projects cover a rapid review of evidence, education analysis, and social and economic policies.