More convenient COVID-19 vaccination options could help uptake, survey finds

More convenient COVID-19 vaccination options could increase uptake among children and adults, according to survey findings published in JAMA Network Open.

Co-author Lisa A. Prosser, PhD, a professor of pediatrics and health management and policy at the University of Michigan and director of the school’s Susan B. Meister Child Health Evaluation and Research Center, told Healio that the project began before the FDA’s emergency use authorizations for pediatric COVID-19 vaccines.

“We were midway through the COVID-19 pandemic, when there were vaccines available for adults but not many vaccines yet available for kids,” Prosser said. “We were interested in how vaccination uptake for children could be different than from adults.”

In May and June 2021, Prosser and colleagues surveyed 1,040 adults about existing and hypothetical vaccination options for adults and children.

They asked participants to pick between two authorized vaccines, each with different attributes — a one-dose vaccine that is 60% effective that comes with 1 day of headache and fatigue and takes 1 hour to be vaccinated or a 2-dose vaccine that is 95% effective, is given 3 to 4 weeks apart, comes with 1 to 2 days of fever and sever chills and takes 2 hours to be vaccinated.

Participants were asked to respond for themselves and then as a proxy for their child. In each prompt, they could choose one of the two vaccines, or neither.

“We essentially mimic the vaccination choice by describing different profiles of vaccination options using a defined set of attributes,” Prosser said. “[We also knew] that some individuals will choose not to be vaccinated, and included that as a choice within the survey, as well. Then we asked the same sets of questions, using the framing of an adult being vaccinated, and next asking the exact same questions except framed as a child being vaccinated. We're able to directly compare what respondents stated that their choices would be for COVID vaccination that matched these characteristics.”

Ultimately, participants indicated that vaccine effectiveness (95% vs. 60%) was a significant attribute, and they also had a stronger preference against rare adverse events for children, although respondents also chose to opt out of 21% of adult vaccination choices and 29% of child vaccination choices.

The researchers also identified a group comprising 9% of respondents who desired shorter waiting times and were described as sensitive to convenience, which Prosser called an “interesting” subgroup.

“We think that this is an important finding,” Prosser said. “For policy and decision-makers that are making recommendations for vaccination policy, as well as for providers, [it’s important to] keep in mind that there may be some individuals that are very sensitive to convenience, and so to be able to provide a vaccine that either has a reduced protocol — only one dose instead of two — or in a setting that is really convenient to the families [such as] the school setting, or potentially even bringing vaccination door to door [could be options].”

Such concerns regarding convenience could impact development of other childhood vaccines, Prosser said.

“We're all looking at the COVID-19 vaccination literature right now and interpreting findings in a way that can inform us about other types of vaccinations, both childhood and adult,” Prosser said. “One of the areas that we plan to [explore is] whether this subgroup that is sensitive to convenience exists for other vaccinations.”