Looking back: Pharmacists share COVID-19 vaccination lessons one year later

Sentiments of vaccine hesitancy and distrust in public health institutions have complicated the government-led coronavirus disease 2019 (COVID-19) vaccine control strategy in the United States. As the first to receive the vaccine, COVID-19 vaccine attitudes among frontline workers are consequential for COVID-19 control and public opinion of the vaccine. In this study, we used a repeated cross-sectional survey administered at 3 time points between 24 September 2020 and 6 February 2021 to a cohort of employees of the University of California, Los Angeles Health and the Los Angeles County Fire Department. The primary outcome of interest was COVID-19 vaccination intent and vaccine uptake. Confidence in COVID-19 vaccines and vaccine uptake rose significantly over time. At survey 1, confidence in vaccine protection was 46.4% among healthcare workers (HCWs) and 34.6% among first responders (FRs); by survey 3, this had risen to 90.0% and 75.7%, respectively. At survey 1, about one-third of participants intended to receive a vaccine as soon as possible. By survey 3, 96.0% of HCWs and 87.5% of FRs had received a COVID-19 vaccine. Attitudes toward vaccine uptake increased over the study period, likely a result of increased public confidence in COVID-19 vaccines, targeted communications, a COVID-19 winter surge in Los Angeles County, and ease of access from employer-sponsored vaccine distribution.

In ongoing efforts to vaccinate communities against COVID-19, pharmacists must address fear and misinformation

Lesbian, gay, bisexual, and transgender (LGBT) populations have higher prevalences of health conditions associated with severe COVID-19 illness compared with non-LGBT populations (1). The potential for low vaccine confidence and coverage among LGBT populations is of concern because these persons historically experience challenges accessing, trusting, and receiving health care services (2). Data on COVID-19 vaccination among LGBT persons are limited, in part because of the lack of routine data collection on sexual orientation and gender identity at the national and state levels. During August 29-October 30, 2021, data from the National Immunization Survey Adult COVID Module (NIS-ACM) were analyzed to assess COVID-19 vaccination coverage and confidence in COVID-19 vaccines among LGBT adults aged ≥18 years. By sexual orientation, gay or lesbian adults reported higher vaccination coverage overall (85.4%) than did heterosexual adults (76.3%). By race/ethnicity, adult gay or lesbian non-Hispanic White men (94.1%) and women (88.5%), and Hispanic men (82.5%) reported higher vaccination coverage than that reported by non-Hispanic White heterosexual men (74.2%) and women (78. 6%). Among non-Hispanic Black adults, vaccination coverage was lower among gay or lesbian women (57.9%) and bisexual women (62.1%) than among heterosexual women (75.6%). Vaccination coverage was lowest among non-Hispanic Black LGBT persons across all categories of sexual orientation and gender identity. Among gay or lesbian adults and bisexual adults, vaccination coverage was lower among women (80.5% and 74.2%, respectively) than among men (88.9% and 81.7%, respectively). By gender identity, similar percentages of adults who identified as transgender or nonbinary and those who did not identify as transgender or nonbinary were vaccinated. Gay or lesbian adults and bisexual adults were more confident than were heterosexual adults in COVID-19 vaccine safety and protection; transgender or nonbinary adults were more confident in COVID-19 vaccine protection, but not safety, than were adults who did not identify as transgender or nonbinary. To prevent serious illness and death, it is important that all persons in the United States, including those in the LGBT community, stay up to date with recommended COVID-19 vaccinations.

In Italy, following the start of the SARS-CoV-2 vaccination campaign, community pharmacies (CPs) were recruited on a voluntary basis in order to administer COVID-19 vaccines as part of their activities. The aim of the present study was to investigate the knowledge, attitudes, and practices regarding SARS-CoV-2 infection prevention, and vaccine acceptance/hesitancy towards COVID-19 and influenza vaccinations among the community pharmacists operating in the Palermo Province. A cross-sectional study was conducted, with two different questionnaires administered before and after the conduction of the vaccination campaign against SARS-CoV-2 at the COVID-19 vaccination center of the Palermo University Hospital (PUH). The baseline survey showed that 64% of community pharmacists (CPs) declared that they planned to vaccinate against SARS-CoV-2, and 58% were vaccinated against influenza during the 2020/2021 season. Factors significantly associated with willingness to receive the COVID-19 vaccination were confidence in vaccines (adjOR 1.76; CI 1.11–2.80), fear of contracting SARS-CoV-2 infection (adjOR 1.50; CI 1.06–2.11), considering COVID-19 vaccination to be the best strategy to counteract SARS-CoV-2 (adjOR 1.79; CI 1.39–2.29), and adherence to influenza vaccination during the 2020/2021 season (adjOR 3.25; CI 2.23–4.25). The adherence among CPs of the Palermo Province to COVID-19 vaccination was 96.5%. From the post-vaccination survey, the main reasons for changing opinions on vaccination adherence were the introduction of mandatory vaccinations, fear of contracting COVID-19, and limitations on work activities in the case of vaccine refusal. The achievement of very high COVID-19 vaccination coverage rates among healthcare professionals (HCPs) in the present study was mainly due to the mandatory vaccination policies; nevertheless, a willingness for COVID-19 vaccination was relatively high among pharmacists before the beginning of the vaccination campaign. HCPs and CPs should receive training on vaccination, which is recommended in the national immunization plan and is also suggested by the respondents in our study, in order to routinely re-evaluate their own vaccination profiles, as well as those of their patients.

In addition to its pulmonary effects, coronavirus disease 2019 (COVID-19) has also been found to cause acute kidney injury (AKI), which has been linked to high mortality rates. In this review, we collected data from 20 clinical studies on post-COVID-19-related AKI and 97 cases of AKI associated with COVID-19 vaccination. Acute tubular injury was by far the most common finding in the kidneys of patients with COVID-19-related AKI. Among patients hospitalized for COVID-19, 34.0% developed AKI, of which 59.0%, 19.1% and 21.9% were Stages 1, 2 and 3, respectively. Though kidney disease and other adverse effects after COVID-19 vaccination overall appear rare, case reports have accumulated suggesting that COVID-19 vaccination may be associated with a risk of subsequent kidney disease. Among the patients with post-vaccination AKI, the most common pathologic findings include crescentic glomerulonephritis (29.9%), acute tubular injury (23.7%), IgA nephropathy (18.6%), antineutrophil cytoplasmic autoantibody-associated vasculitis (17.5%), minimal change disease (17.5%) and thrombotic microangiopathy (10.3%). It is important to note that crescentic glomerulonephritis appears to be more prevalent in patients who have newly diagnosed renal involvement. The proportions of patients with AKI Stages 1, 2 and 3 after COVID-19 vaccination in case reports were 30.9%, 22.7% and 46.4%, respectively. In general, clinical cases of new-onset and recurrent nephropathy with AKI after COVID-19 vaccination have a positive prognosis. In this article, we also explore the underlying pathophysiological mechanisms of AKI associated with COVID-19 infection and its vaccination by describing key renal morphological and clinical features and prognostic findings.

BackgroundClinical and real-world effectiveness data for the COVID-19 vaccines have shown that they are the best defense in preventing severe illness and death throughout the pandemic. However, in the US, some groups remain more hesitant than others about receiving COVID-19 vaccines. One important group is long-term care workers (LTCWs), especially because they risk infecting the vulnerable and clinically complex populations they serve. There is a lack of research about how best to increase vaccine confidence, especially in frontline LTCWs and healthcare staff. Our aims are to: (1) compare the impact of two interventions delivered online to enhanced usual practice on LTCW COVID-19 vaccine confidence and other pre-specified secondary outcomes, (2) determine if LTCWs’ characteristics and other factors mediate and moderate the interventions’ effect on study outcomes, and (3) explore the implementation characteristics, contexts, and processes needed to sustain a wider use of the interventions.MethodsWe will conduct a three-arm randomized controlled effectiveness-implementation hybrid (type 2) trial, with randomization at the participant level. Arm 1 is a dialogue-based webinar intervention facilitated by a LTCW and a medical expert and guided by an evidence-based COVID-19 vaccine decision tool. Arm 2 is a curated social media web application intervention featuring interactive, dynamic content about COVID-19 and relevant vaccines. Arm 3 is enhanced usual practice, which directs participants to online public health information about COVID-19 vaccines. Participants will be recruited via online posts and advertisements, email invitations, and in-person visits to care settings. Trial data will be collected at four time points using online surveys. The primary outcome is COVID-19 vaccine confidence. Secondary outcomes include vaccine uptake, vaccine and booster intent for those unvaccinated, likelihood of recommending vaccination (both initial series and booster), feeling informed about the vaccines, identification of vaccine information and misinformation, and trust in COVID-19 vaccine information provided by different people and organizations. Exploration of intervention implementation will involve interviews with study participants and other stakeholders, an in-depth process evaluation, and testing during a subsequent sustainability phase.DiscussionStudy findings will contribute new knowledge about how to increase COVID-19 vaccine confidence and effective informational modalities for LTCWs.Trial registrationNCT05168800 at ClinicalTrials.gov, registered December 23, 2021.

Associations between trust in public health, vaccine confidence, and COVID-19 vaccination among American adults.

Background: Both hepatitis B and coronavirus vaccines are important requirement for all health science student because of their potential exposure to hepatitis B and coronavirus diseases during their clinical experience. Vaccine uptake has recently been affected by lack of confidence to their efficacy and safety. This attitude is vaccine dependent and understanding of the determinants will help to prevent vaccine hesitancy. This study was designed to compare the attitude of health science student toward hepatitis B vaccine and coronavirus vaccine. Method: A descriptive cross-sectional study carried out among students of one of the colleges of health sciences in Enugu Nigeria. The students comprised of medical students, medical laboratory students and nursing students who visit the hospital for their clinical postings and experiences. Three, two and two classes in the departments of medicine, medical laboratory science and nursing science respectively met the inclusion criteria for the study. They are six hundred and two students in the three departments of the college. Two classes were selected from the department of medicine and one class each from the department of medical laboratory science and nursing science respectively using simple random sampling method. A total of 303 (135; medicine students, 85; medical laboratory and 83; nursing students) students were in the selected classes and all of them participated in the study. The questionaries were distributed to all the students in the selected classes during their lectures. A pre-tested self-administered questionnaire was used to assess the knowledge, attitude and vaccine status, and beliefs concerning Hepatitis B vaccines and coronavirus vaccine. The questions on knowledge were adopted from related literatures while questions on attitude were adopted from Parental Attitude on Childhood Vaccine (PACV) questions and Global Vaccine Confidence (GVC) survey. The findings and scores were analysed using IBM SPSS Statistic software for windows (SPSS statistical software V.21 (IBM Corp. 2019). Total of 11 responses were incomplete in either one or more questions and they were all removed bringing the total number of valid participants to 292. The age of the respondents was grouped, and the simple mean obtained. Scores on knowledge were calculated by scoring correct response as 1 and scoring incorrect as 0. All ‘I don’t know’ responses were regarded as negative answer. A score of less than 50% correct responses was regarded as ‘less than average’, and 50% or more correct responses was regarded as ‘above average’. The attitude of the students towards hepatitis B vaccine and coronavirus vaccine were compared using chi-square and the p-value less than 0.05 was regarded as statistically significant. Results: Out of 303 students, 292 responded to all the questions while 11 were incomplete. Two hundred and four participants (69.9) were females while 88(30.1) were males with the mean age of 22.6 SD 2.6. The medical students, nursing students and medical laboratory students contributed to 134(45.9), 81(27.7) and 77(26.4) respectively. On the general knowledge, 282(96.6%) had knowledge above average. Although the responses to the question ‘Upon discovery of vaccine for a particular disease, the “efficacy” of the vaccine will be considered before approval by the appropriate organizations’ were little above average, 161(55.1). The students had better attitude towards hepatitis B vaccine than coronavirus vaccine. For instance, 114(39%) students had decided not to have coronavirus vaccine against 43(14.7%) for hepatitis B vaccine. Again, 204(69.9) and 125(42.8) expressed concern on the ‘safe’ of coronavirus vaccine and hepatitis B vaccine, respectively. Similar responses were observed on the question concerning the side effect of the two vaccines. The questions on the ‘Trust”: the respondent expressed significant distrust to their doctors, government, media, and their spiritual leader concerning the coronavirus than the hepatitis B vaccine. The difference in the responses on the ‘efficacy’ of the two vaccine was not significant. In the practice domain, the majority of the students have not had both hepatitis B and coronavirus vaccine. There was significant difference between those who indicated wiliness to take hepatitis B vaccine and coronavirus vaccine as soon as they are available. In conclusion: The knowledge about vaccine as expressed by the students in this study was above average. They expressed negative attitude to coronavirus vaccine than hepatitis B vaccine. The student expressed concern on the efficacy of the two vaccines and the vaccine generally. It was also observed that many of the students have not had hepatitis B vaccine despite their willingness. It therefore important to introduce the concept of vaccine confidence in the health science curriculum and emphasis should be made on the efficacy of vaccines. There is also a need to scale up hepatitis B vaccine coverage among students of health sciences.

BackgroundPatients with autoimmune rheumatic disease (AIRD) are at risk of severe COVID-19 infection and vaccine has been demonstrated to be able to reduce the severity of infection. Malaysia has a...

With the emergence of the highly transmissible Omicron variant, large-scale vaccination coverage is crucial to the national and global pandemic response, especially in populous Southeast Asian countries such as the Philippines and Malaysia where new information is often received digitally. The main aims of this research were to determine levels of hesitancy and confidence in COVID-19 vaccines among general adults in the Philippines and Malaysia, and to identify individual, behavioural, or environmental predictors significantly associated with these outcomes. Data from an internet-based cross-sectional survey of 2558 participants from the Philippines (N = 1002) and Malaysia (N = 1556) were analysed. Results showed that Filipino (56.6%) participants exhibited higher COVID-19 hesitancy than Malaysians (22.9%; p < 0.001). However, there were no significant differences in ratings of confidence between Filipino (45.9%) and Malaysian (49.2%) participants (p = 0.105). Predictors associated with vaccine hesitancy among Filipino participants included women (OR, 1.50, 95% CI, 1.03-1.83; p = 0.030) and rural dwellers (OR, 1.44, 95% CI, 1.07-1.94; p = 0.016). Among Malaysian participants, vaccine hesitancy was associated with women (OR, 1.50, 95% CI, 1.14-1.99; p = 0.004), social media use (OR, 11.76, 95% CI, 5.71-24.19; p < 0.001), and online information-seeking behaviours (OR, 2.48, 95% CI, 1.72-3.58; p < 0.001). Predictors associated with vaccine confidence among Filipino participants included subjective social status (OR, 1.13, 95% CI, 1.54-1.22; p < 0.001), whereas vaccine confidence among Malaysian participants was associated with higher education (OR, 1.30, 95% CI, 1.03-1.66; p < 0.028) and negatively associated with rural dwellers (OR, 0.64, 95% CI, 0.47-0.87; p = 0.005) and online information-seeking behaviours (OR, 0.42, 95% CI, 0.31-0.57; p < 0.001). Efforts should focus on creating effective interventions to decrease vaccination hesitancy, increase confidence, and bolster the uptake of COVID-19 vaccination, particularly in light of the Dengvaxia crisis in the Philippines.

Background: Coronavirus disease 2019 (COVID-19) vaccine development is the best approach to fight the disease. However, rising vaccine hesitancy can make widespread vaccine application difficult. Objectives: To explore health care workers' attitudes towards the COVID-19 vaccine and find the reasons lying behind vaccine hesitancy among participants. Methods: Our study was a cross-sectional survey. An anonymous online questionnaire was sent to a sample of health care workers living and working in the Middle East region. Data collected included demographic data, educational attainment, household crowding, risk factors for severe COVID-19 infection, influenza vaccination history, and questions about COVID-19 vaccine acceptance. Results: We received 864 validated responses. The study included 365 physicians, 391 nurses, and 108 allied professions. Females represented 61% of participants and 98.5% of participants were below 65 years old. Around 60% of participants were hesitant to get the COVID-19 vaccine. The commonest reasons for hesitancy were lack of information and fear of side effects. Vaccine acceptance was higher among males (p&lt; 0.001), physicians (p= 0.017), participants with medical risk factors (p= 0.017), and participants vaccinated against influenza (p&lt; 0.001). After control for other factors, male (OR, 1.94; CI 1.42-2.66), married participant (OR, 1.89; CI 1.22-2.92), living in a less crowded accommodation (OR, 1.33; CI 1.11-1.59), and who got influenza vaccine (OR, 1.64; CI 1.13-2.37) tended to accept the COVID-19 vaccine more likely. Conclusion: Rates of vaccine hesitancy among health care workers were high. The current pandemic offers an opportunity to establish better vaccine confidence towards the COVID-19 vaccine and vaccines in general.

Background: People who use drugs (PWUD) are at high risk for COVID-19 infection, morbidity, and mortality. COVID-19 vaccines are safe and effective at reducing serious illness and death from COVID-19. There are sparse data on the perceptions and willingness of PWUD to receive COVID-19 vaccination. Materials and Methods: In order to assess the perceptions of, and willingness to receive, COVID-19 vaccination among PWUD, we conducted a rapid survey-based assessment of 100 PWUD in NYC (Spring 2021) who reported not having received COVID-19 vaccination and who reported past 30-day illicit drug use. Results: More than 80% of respondents agreed that personally receiving a COVID-19 vaccine was important for the health of others in the community, and endorsing this belief was significantly associated with COVID-19 vaccine willingness reflecting a high prevalence of altruistic beliefs (p-value: 0.01). Other reported perceptions that were significantly associated with COVID-19 vaccine willingness were believing that COVID-19 vaccines are safe for PWUD and trusting COVID-19 information from their healthcare providers (p-values < 0.05). That said, 62% reported being unwilling to receive a COVID-19 vaccine, and 70–83% had concerns about general vaccine safety/efficacy. Examining pairs of questions to explore potential ambivalence between vaccine endorsement and vaccine concerns identified that 56–65% simultaneously reported vaccine safety/efficacy concerns and beliefs that vaccination was an important intervention. Of the 75 respondents who reported past 30-day use of harm reduction and/or substance use disorder (SUD) programs, nearly 90% reported these programs as trusted sources of COVID-19 information. Conclusion: Most participants reported altruistic beliefs about the role of vaccines for community health, including COVID-19 vaccines, and this altruism was associated with willingness to be vaccinated against COVID-19. These findings suggest a complex relationship between beliefs about the role of vaccination in community health and the safety/efficacy of vaccines; this ambivalence suggests that COVID-19 vaccine willingness may not be firmly fixed, indicating potential opportunities to address questions and build vaccine confidence. Harm reduction and SUD programs could be leveraged to further engage PWUD in receipt of COVID-19 information and/or vaccination. Recognizing vaccine ambivalence, emphasizing collective and individual benefits of vaccination, and messaging from trusted sources may be promising approaches to increase vaccination in this population.

This In Brief was accepted July, 2021. Due to the Pediatrics in Review process from authorship to publication and the rapidly evolving nature of the COVID-19 pandemic, this In Brief may not reflect the most recent events.Severe acute respiratory syndrome coronavirus 2 has infected hundreds of millions of individuals globally, and millions have died as a result of the associated coronavirus disease 2019 (COVID-19). Although severe COVID-19 disease has predominantly affected older adults, children have also been affected. As of early May 2021, nearly 4 million total cases of COVID-19 were reported in children, representing 14% of all cases. With wider availability and uptake of vaccination by adults, increased rates of infection are being reported in the unvaccinated pediatric population. New COVID-19 variants, loosening of public health measures, and lifting of restrictions on school activities are also driving increased infections in children. Serious illness and death are lower in children; however, after symptomatic or asymptomatic infection, they are vulnerable to multisystem inflammatory syndrome in children (MIS-C). This postinfectious, immune-mediated syndrome can lead to serious, life-threatening illness in otherwise healthy children. Children can also experience post–COVID-19 syndrome or long COVID-19 and suffer from persistent symptoms at the postviral stage of the disease. The COVID-19 pandemic has disrupted children’s education and recreational activities and has had a substantial effect on children’s physical, mental, and emotional health.Data suggest that vaccines are highly effective in preventing severe COVID-19, act against many new variants, and are incredibly safe. The Pfizer-BioNTech (mRNA) COVID-19 vaccine was initially authorized for those 16 years and older and the Moderna (mRNA) and Johnson and Johnson (adenovirus-vectored) vaccinations for those 18 years and older. Recently the Food and Drug Administration (FDA) provided Emergency Use Authorization for adolescents 12 to 15 years old to receive the Pfizer-BioNTech vaccination after promising clinical trial results. The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices has also recommended its use in adolescents. The Pfizer-BioNTech trial enrolled 2,260 participants, and the vaccine was 100% effective in preventing symptomatic infection in those 12 to 15 years old. The vaccine also exhibited appropriate immunogenicity and mostly mild to moderate reactogenicity symptoms. All the children were from the United States, and most identified as white (85.9%) and non-Hispanic/Latino (88.2%). The dose of the Pfizer-BioNTech vaccination in 12- to 17-years-olds is the same as that in adults. Moderna completed a clinical trial (TeenCOVE) of 12- to younger than 18-year-olds with encouraging results. TeenCOVE enrolled more than 3,700 participants in the United States with zero infections in fully vaccinated adolescents. In addition, the vaccine was highly effective (93%) 14 days after the first dose, and the safety and tolerability profile was similar in adolescents and adults. Emergency Use Authorization for the Moderna vaccine for adolescents is expected in early summer 2021.Pfizer-BioNTech and Moderna are currently conducting phase I clinical trials in children aged 6 months to younger than 12 years. Once age-specific doses are selected, larger clinical trials will be conducted this summer. Determining appropriate dosing is an important consideration as vaccination expands to younger children. Both the Moderna and Pfizer-BioNTech clinical trials in children are being performed as age de-escalation/dose escalation studies. It is probable that a smaller dose will produce adequate immune response, and the recommended doses may be different by age group. The results from these studies are anticipated in the second half of 2021, and if safety and immunogenicity are confirmed, authorization for vaccination of younger children could occur in late 2021 or early 2022.Although allergic reactions to vaccine ingredients are rare, children who have a history of severe allergic reaction to any ingredient in the vaccination should not get a COVID-19 vaccine. Children who have severe allergies to other entities should plan for a slightly longer observation after vaccination. The CDC allows vaccination of children with a history of MIS-C, although currently there are no data on the safety or efficacy in this population. The mechanism of the hyperinflammatory immune response in MIS-C is unclear, and the risk of recurrence after vaccination is unknown.Adolescents and older children had similar local reactogenicity as adults in the Pfizer-BioNTech clinical trial. Adolescents reported pain at the injection site more commonly after the second dose. Systemic responses were also similar, with fatigue (60% after dose 1, 66% after dose 2) and headache (55% after dose 1, 64.5% after dose 2) occurring most often. Chills, muscle pain, joint pain, and fever also occurred. Fever was slightly more common in 12- to 15-year-olds compared with adults, with 0.9% of children experiencing temperatures of 102°F to 104°F (38.9°C–40.0°C) and 0.1% of children with temperatures higher than 104°F (>40.0°C). Adverse effects typically lasted 1 to 3 days. Children and adolescents are more likely to have a more robust immune response and thus might experience more adverse effects than their parents or guardians.Survey data from the CDC and the University of Iowa suggest that children and parents feel most comfortable receiving COVID-19 vaccinations at their primary care physicians’ offices. This underscores the importance of ensuring that pediatricians are able to store and administer the vaccines. Recently after a review of data, the FDA authorized that undiluted, thawed Pfizer-BioNTech vaccine vials can be refrigerated for 1 month. Out of an abundance of caution, COVID-19 vaccines were previously recommended to be administered alone and spaced 2 weeks from other vaccinations. The CDC now allows for COVID-19 vaccines and other vaccinations to be given concurrently after evaluation of safety data for COVID-19 vaccines currently authorized by the FDA. It is not known whether the reactogenicity of the COVID-19 vaccine increases with co-administration, particularly with vaccines known to illicit robust immune responses. This is an important issue to consider for childhood vaccination because health supervision visits for routine care and vaccinations are important opportunities for COVID-19 vaccine administration. In addition, many children have had delayed vaccinations during the COVID-19 pandemic and will need catch-up vaccination schedules in addition to receipt of a COVID-19 vaccine.COVID-19 vaccinations are a crucial and promising step to containment of the pandemic. However, many parents are reluctant to vaccinate their children against COVID-19. A recent national survey found that 27% of mothers and 11% of fathers are extremely unlikely to vaccinate their children against COVID-19. Thoughts on vaccination differed based on parents’ education, income, and political party. A Kaiser Family Foundation survey found that parents’ intentions for children’s COVID-19 vaccination largely align with their own vaccination intentions. Pediatricians remain trusted resources for families and essential advocates who can listen to parents’ questions and provide more information regarding COVID-19 vaccination. Many resources are available for providers, including information from the CDC, the American Academy of Pediatrics, and the Children’s Hospital of Philadelphia Vaccine Education Center.Children younger than 15 years account for nearly one-fourth of the global population, remain at risk for both COVID-19 and sequelae of infection, and can spread disease among themselves and to older individuals. Adolescent vaccinations have thus far been highly effective and safe, with further clinical trials underway to expand use to younger children. Ensuring that children are vaccinated against COVID-19 has implications for return to school and activities, quarantine after exposure, and helping children and parents regain a sense of normalcy.Immunization of children and adolescents is an essential strategy in further containing the COVID-19 pandemic. Continued expansion of vaccination includes benefits to the individual who is being vaccinated, his or her family members, the community, and the public health benefits in striving to reach herd immunity. I find it a remarkable accomplishment of science that a safe vaccine has been developed in such a timely manner. Yet, vaccine hesitancy must be addressed in addition to strategies to enhance access of COVID vaccines to all who need them. We, as pediatricians, need to meet with parents and their children/adolescents, listen carefully to their concerns, provide accurate information that is easy to understand in respectful and nonjudgmental ways, answer questions, and promote the trusting relationship we all strive for in our relationships with patients and families. In addition, practices and communities need to continue to find creative strategies to ensure vaccine access to all patients. Although vaccination in the primary care provider’s office is optimal in maintaining the medical home and ensuring that all health-care issues are addressed, the pandemic has allowed us to think creatively in offering vaccine clinics in the community, through churches, sports centers and events, schools, pharmacies, and other locations to maximize the ease in obtaining the vaccine. These strategies, while helping our country and public health system now, will also be resources for future vaccine rollouts and minimizing health disparities.

Moving the needle on racial disparity: COVID-19 vaccine trust and hesitancy

Extensive efforts have been directed toward developing an effective vaccine to fight against the Coronavirus Disease 2019 (COVID-19); however, hesitancy to receive COVID-19 vaccinations has become detrimental to overcoming the COVID-19 pandemic. Although the U.S. Military instated a COVID-19 vaccine mandate, some members were still hesitant to receive the vaccine. To determine the efficacy of a program focused on vaccine hesitation, a program evaluation was conducted on a COVID-19 vaccine educational intervention (hereafter COVID-19 Educational Presentation) for trainees at Lackland Air Force Base, TX, in September 2021. Objectives of the educational session included (1) determining the participants' level of confidence that the COVID-19 vaccines are safe and effective, (2) understanding the concern for long-term side effects from COVID-19 vaccinations, and (3) identifying the driving forces behind hesitancy to receive a COVID-19 vaccination. We reviewed data collected from the COVID-19 Vaccine Educational Presentation; it consisted of a PowerPoint presentation addressing common questions and myths about COVID-19 vaccines. A survey instrument called the COVID-19 Hesitancy and Confidence Survey was created to assess attitudes to receive the COVID-19 vaccine. Two voluntary COVID-19 Educational Presentations were given in September 2, 2021, months prior to the Air Force's COVID-19 vaccine mandate deadline; 128 trainees participated in the assessment surveys. Overall, the educational intervention increased confidence to receive the COVID-19 vaccine increased by 12.6% (t = -7.928, P < 0.001). The COVID-19 Educational Presentation increased confidence and decreased hesitancy to receive the COVID-19 vaccine. Vaccine educational programs should continue in the military population to help combat misinformation and ensure that our military force is fully vaccinated and able to maintain mission readiness.