Peer-reviewed article
Parental vaccination status and other socioeconomic determinants shaping COVID-19 vaccine uptake in children and adolescents in Singapore.
Jinghao Nicholas Ngiam, Alex J W Yap, Liang En Wee, Matthew Chung Yi Koh, Soon Kok Lim et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined COVID-19 vaccination uptake among children and adolescents aged 5-17 years in Singapore between June 2021 and April 2022. Vaccination coverage declined with each additional dose, with adolescents aged 12-17 years showing higher uptake (95.8% for primary vaccination) than younger children aged 5-11 years (75.8% for primary vaccination). Parental vaccination status was the strongest predictor of whether children received COVID-19 vaccines, alongside other factors like socioeconomic status and household structure.
Key points
- Among adolescents aged 12-17 years, 95.8% completed primary vaccination, 92.5% received a first booster, and 18.6% received a second booster
- Among children aged 5-11 years, uptake was 75.8% for primary vaccination, 46.1% for first booster, and 20.2% for second booster
- Parental COVID-19 vaccination status was the strongest predictor of child vaccination uptake
- Regular influenza re-vaccination was consistently associated with shorter time-to-vaccination
- Vaccination uptake was shaped by socioeconomic status, household structure, and parental vaccination history
Limitations
This is an observational study using national-level data, so it describes patterns of uptake but cannot establish causal relationships. The study cannot explain the reasons why parental vaccination status influences child vaccination decisions or whether other unmeasured factors contribute to disparities.
Abstract
OBJECTIVES: During the pandemic, achieving high and equitable COVID-19 vaccination coverage in children and adolescents was essential for reducing transmission, protecting vulnerable household members, and limiting disruption to schools. We examined real-world uptake of COVID-19 vaccine doses among children and adolescents in Singapore, where vaccinations for those aged 12-17 years and 5-11 years were introduced during the Delta and Omicron waves, respectively. METHODS: We conducted a retrospective cohort study using national-level data for all children and adolescents aged 5-17 years eligible for vaccination between June 1, 2021, and April 30, 2022. Time-to-vaccination for each dose was analyzed, stratified by age group. RESULTS: Among 442,399 children and adolescents, uptake declined progressively with each additional vaccination dose. Among adolescents aged 12-17 years, 95.8% completed primary vaccination, 92.5% received a first booster, and 18.6% received a second booster. Corresponding uptake among children aged 5-11 years was 75.8%, 46.1%, and 20.2%, respectively. Parental COVID-19 vaccination status was the strongest predictor of uptake. Regular influenza re-vaccination was consistently associated with shorter time-to-vaccination and showed stronger association with booster vaccination. CONCLUSION: Vaccination uptake was shaped by socioeconomic status, household structure, and parental vaccination. Tailored, family-centered strategies may help support rollout of vaccination programs.