1175. Influenza Vaccine Hesitancy in Hospitalized Children, Before and During the COVID-19 Pandemic

Abstract Background Influenza vaccine is recommended for all children ≥6 months, yet uptake is suboptimal. We aimed to quantify child influenza vaccine coverage and identify factors associated with influenza vaccine hesitancy (VH) before and during the COVID-19 pandemic. Methods We conducted a prospective, repeated cross-sectional assessment in English and Spanish of caregiver influenza knowledge, attitudes, behaviors, and associated VH among hospitalized children 6 months through 18 years at a large pediatric medical institution. Caregivers were enrolled 4-5 days per week, between 12/11/2019--1/31/2020 and 12/8/2020--4/5/2021. VH was assessed using the Parent Attitudes about Childhood Vaccines (PACV) survey; PACV score ≥50 denoted VH. Descriptive statistics and multivariable logistic regression were used. Results During 2019-2020 and 2020-2021 influenza seasons, 269/282 (95%) and 295/307 (96%) of approached caregivers enrolled, respectively. By caregiver report, 94% of children in 2019-2020 and 91% in 2020-2021 were up-to-date with routine childhood vaccines (p=0.13). Specific to influenza vaccine, 73% and 68% of children received or planned to receive influenza vaccine in 2019-2020 and 2020-2021, respectively (p=0.13). Based on PACV score, 13% of parents were VH in 2019-2020 compared with 17% in 2020-2021 (p=0.24; Figure 1). Caregivers who had not/did not intend to vaccinate their children had a higher family income (71% vs. 57% >&30,000, p< 0.01) and were less likely to be Hispanic/Latino (35% vs. 47%, p=0.02). 77% of caregivers were satisfied with information about influenza vaccine received from healthcare providers. Overall, 36% believed “you can get the flu from the flu shot.” In 2020-2021, caregivers were less likely to believe that “flu can be a dangerous infection in children,” to be “scared of my child getting the flu” and to agree that “all children over 6 months of age should receive the flu shot every year” (Table 1). Table 1. Caregiver knowledge and attitudes about seasonal influenza vaccine, 2019-20 versus 2020-21 Figure 1. Influenza vaccine uptake by PACV score during 2019-2020 (a) and 2020-2021 (b) seasons Conclusion During the COVID-19 pandemic, caregivers of hospitalized children were less concerned about influenza than pre-pandemic and misinformation about influenza and influenza vaccine persisted. Increased efforts may be needed to educate caregivers about the importance of influenza immunization during the 2021-22 season. Disclosures C. Mary Healy, MD, Dexcom (Shareholder)Intuitive (Shareholder)Quidel Corporation (Shareholder)Up to Date (Other Financial or Material Support, Honorarium)Vapotherm (Shareholder)

. All-Site Weighted Average Incidence Rate Ratios, Children <5> * Total sites indicates number of sites with incidence rate data included and pre/ post sites indicates number of sites with both pre-and post-PCV data to estimate IRRs for each outcome. ** Year 0 indicates the year of PCV10/13 introduction and year -1 indicates the last year of PCV7 use prior to PCV10/13 introduction.
Conclusion. All-serotype IPD in children < 5 years declined following both PCV10 and PCV13 use, driven by substantial declines in VT serotypes and offset by increases in nonPCV13 STs. ST19A decreased among PCV13-sites, mitigating replacement disease occurring after PCV7 use, but increased, on average, among PCV10-sites. Changes in ST3 were heterogeneous, increasing in some sites and no change from baseline in others. Data from low-income and high-burden settings were limited.
Disclosures Background. Despite widespread use of pneumococcal conjugate vaccines (PCVs) in children, morbidity and mortality caused by pneumococcal disease (PD) remain high, in part due to the emergence of disease caused by non-vaccine serotypes (STs). In addition, many children do not receive the recommended number of PCVs on schedule and, therefore, are at risk for PD. V114 is an investigational 15-valent PCV that contains two epidemiologically important STs, 22F and 33F, in addition to the 13 STs present in the licensed 13-valent PCV (PCV13; Prevnar 13 ™ ). This Phase 3 descriptive study evaluated the safety and immunogenicity of V114 and PCV13 when given as catch-up vaccination in children who are pneumococcal vaccine-naïve or previously immunized with lower valency PCVs.
Methods. Solicited adverse events (AEs) were collected for 14 days after each vaccination. Serious adverse events (SAEs) were collected throughout study participation.
Immunogenicity was evaluated by anti-pneumococcal polysaccharide ST-specific immunoglobulin G (IgG) geometric mean concentrations (GMCs) at 30 days post-last vaccination.
Results. 606 healthy children, aged 7 months through 17 years, were randomized (double-blind) to receive V114 (n=303) or PCV13 (n=303) via age-appropriate catch-up vaccination schedules (Table 1). V114 had an acceptable safety profile and was well tolerated. Similar proportions of children aged 7-11 months and 2-17 years reported AEs in the V114 and PCV13 groups. A larger proportion of children aged 12-23 months reported AEs in the V114 group (79%) than the PCV13 group (59%). The proportion of children who reported SAEs was comparable among vaccination groups (V114 and PCV13, respectively, 7-11 months: 10.9%, 7.8%; 12-23 months: 6.5%, 6.3%; 2-17 years: 2.3%, 2.3%). No SAEs were reported to be vaccine-related, and no deaths occurred. At 30 days after the last PCV dose, ST-specific IgG GMCs were comparable for the 13 shared STs and were higher in the V114 group for 22F and 33F. Table 1. Catch-up vaccination schedules in V114-024 Conclusion. Catch-up vaccination with V114 in healthy children aged 7 months through 17 years had an acceptable safety profile, was well tolerated, and provided comparable immune responses to the 13 serotypes shared with PCV13, and higher immune responses to serotypes 22F and 33F.
Disclosures Background. Influenza vaccine is recommended for all children ≥6 months, yet uptake is suboptimal. We aimed to quantify child influenza vaccine coverage and identify factors associated with influenza vaccine hesitancy (VH) before and during the COVID-19 pandemic.
Caregivers who had not/did not intend to vaccinate their children had a higher family income (71% vs. 57% >$30,000, p< 0.01) and were less likely to be Hispanic/ Latino (35% vs. 47%, p=0.02). 77% of caregivers were satisfied with information about influenza vaccine received from healthcare providers. Overall, 36% believed "you can get the flu from the flu shot. " In 2020-2021, caregivers were less likely to believe that "flu can be a dangerous infection in children, " to be "scared of my child getting the flu" and to agree that "all children over 6 months of age should receive the flu shot every year" (Table 1). Table 1 Conclusion. During the COVID-19 pandemic, caregivers of hospitalized children were less concerned about influenza than pre-pandemic and misinformation about influenza and influenza vaccine persisted. Increased efforts may be needed to educate caregivers about the importance of influenza immunization during the 2021-22 season.