P3.F117: Describing Barriers to Respiratory Virus Vaccination in High-Risk Pediatric Populations: Insights from a Multi-Year Survey at a Children’s Healthcare System in a Predominantly Rural State

Background: The seasonal Influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are highly contagious viruses and can lead to severe respiratory illness, complications, and even death, particularly in vulnerable populations such as the elderly, young children, and individuals with underlying health conditions. The rapid spread of COVID-19, the illness caused by SARS-CoV-2, has highlighted how quickly these viruses can disrupt societies, economies, and healthcare systems. Similarly, seasonal Influenza, while often perceived as less severe, continues to be a major cause of morbidity and mortality worldwide. Vaccination against respiratory viruses like Influenza and SARS-CoV-2 is critically important for high-risk pediatric populations with chronic respiratory conditions, who are disproportionately affected by complications from these illnesses (Bjornson et al., 2000). Despite its significance for prevention, vaccination rates in this population remain suboptimal.

Methods: Analysis of a multi-year survey (2021-2023) was conducted at pediatric specialty healthcare clinics during peak respiratory seasons in a predominantly rural state in order to better understand the reasons behind the individual patient’s choice to receive the recommended vaccinations. This project was deemed exempt by the Institutional Review Board (IRB#275037).

Results: This survey (n=865) revealed notable findings about the flu vaccine (Figure 1). For instance, only 37.5% of children in high-risk categories had already received it. When asked if they would like to receive the vaccination, only 36.2% of those who had not already received it wanted to receive it. The COVID-19 vaccine had even lower vaccine uptake at 27.8% prior to their visit and 5.6% who wanted to receive it (Figure 2).

Analysis of those who provided reasoning for their declination of vaccination (n=196) indicated concerns about vaccine efficacy (12% of respondents), concerns about side effects (10% of respondents), and a desire to obtain the vaccination elsewhere at another time (35% of respondents), were the leading reasons for vaccine hesitancy.

Conclusion: These results align with prior studies, which show that parental beliefs and knowledge significantly impact vaccination decisions (Sampson et al., 2011). Additionally, issues related to vaccine access and the quality of healthcare provider relationships are also well documented and significant barriers to vaccination (Bhat-Schelbert et al., 2012).

This project illuminated trends that are critical in designing strategies to improve vaccination rates. It emphasized the need for targeted educational initiatives to address misconceptions and fears that patients and parents may have. Enhancing access to vaccination services and fostering robust provider-patient communication, especially for children with chronic health conditions, are also key to increasing vaccination rates (Kong et al., 2020).

This project offers comprehensive insight into the challenges in vaccinating high-risk pediatric populations. It aims to provide healthcare professionals and other stakeholders with targetable concerns that can be addressed to increased vaccination uptake and better protection for vulnerable groups against respiratory viruses.