Abstract
As the coronavirus disease 2019 (COVID-19) pandemic continues, COVID-19 vaccine hesitancy has become a serious public health issue. Therefore, it is critical to identify children and adolescents who are not vaccinated. The objective of this study was to assess and identify predictors of pediatric COVID-19 vaccine uptake in the United States (U.S.). The study was based upon a cross-sectional cohort of U.S. children and adolescents aged 5 to 17 years. We used overall U.S. COVID-19 Vaccine administration data at county level from Centers for Disease Control and Prevention (CDC) to examine the pediatric COVID-19 vaccine uptake. Analyses were carried out while accounting for clustering by state using random effects. Hierarchical models were built using both the frequentist approach and the Bayesian approach, adjusting for race, ethnicity, educational attainment, health insurance status, household income, recommended vaccination coverage, vaccine exemption policies, influenza vaccine uptake, election votes, attitude about vaccine safety, news consumption behaviours, health seeking behaviours, and trust in social media. The pediatric COVID-19 vaccine uptake coverages were significantly lower in counties with a higher percentage of population who are Republican voters, have low educational attainment, low household income, and some races. Our study provides a road map to help health professionals, community leaders, and other trusted sources to identify priority groups for developing tailored approaches in counties across the U.S to increase pediatric COVID-19 vaccine uptake, which is effective for prevention and control of SARS-COV-2.Â