Peer-reviewed article
Using latent class analysis of survey data to explore parent behaviors and attitudes regarding children's COVID vaccinations.
Zachary H Seeskin, Michael Steffan, Brian Geistwhite, Maggie Yarbrough, Michael P Chen et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed survey data from parents and guardians of US children aged 6 months to 17 years to identify distinct groups based on their COVID vaccination behaviors and attitudes. Using statistical analysis, researchers found several population segments, including parents who vaccinated their children despite vaccine safety concerns and those who remained unvaccinated despite trusting the vaccine and intending to vaccinate. The study found that vaccination hesitancy increased over time and identified demographic and social factors associated with different vaccination attitudes.
Key points
- Latent class analysis identified heterogeneous population segments with varying combinations of vaccination status, intent, and confidence in vaccine safety
- One segment showed vaccinated children despite low confidence in vaccine safety; another showed unvaccinated children despite high confidence and high vaccination intent
- Vaccination hesitancy was the fastest-growing segment during the October 2021 to April 2023 study period
- Socioeconomic status and race/ethnicity were associated with different vaccination attitude classes
- Social factors such as having vaccinated family/friends and provider recommendations were associated with more favorable vaccination attitudes
Limitations
The study is exploratory and does not establish causal relationships between identified factors and vaccination outcomes. The analysis is based on cross-sectional survey data and cannot determine why attitudes changed over time or predict future vaccination behavior.
Abstract
We conducted exploratory data analyses of the National Immunization Survey-Child COVID Module (NIS-CCM). NIS-CCM is a random digit dialing survey of parents and guardians of 6-month- through 17-year-old children. We conducted latent class analysis to identify different population segments of children according to combinations of parental/guardian intent, attitudes, and behaviors regarding their children's COVID vaccinations. We analyzed data collected between October 2021 and April 2023. The latent class model variables with the greatest variation in conditional probabilities across latent classes included vaccination status, intent to vaccinate, and confidence in the safety of COVID vaccine. The latent classes included one with vaccinated children despite low confidence in vaccine safety and one with unvaccinated children despite high confidence in vaccine safety and high vaccination intent. The latent class that increased the most in size over the period studied was the class most hesitant to vaccination. We further analyzed demographic and environmental characteristics associated with membership in different latent classes using multinomial logistic regression, with the goal of informing strategies to increase vaccination coverage with different population segments. Socioeconomic status and race/ethnicity were associated with latent class membership. Specific social and environmental factors, such as having many family and friends' children vaccinated for COVID and receiving a provider's recommendation for vaccination were associated with more favorable-to-vaccination class membership. While the exploratory analyses do not establish causal relationships, the research shows the value of latent class analysis with high-quality survey data to inform further research on strategies to increase vaccination coverage.