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Association of Discrimination and Health Care Experiences With Incomplete Infant Vaccination During COVID-19

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To identify the key insights or developments described in this article
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The COVID-19 pandemic has profoundly affected the lives of pregnant individuals and their infants, resulting in prenatal health care disruptions,1 reduced duration of postpartum hospitalization, a sharp decrease in infant vaccination rates,2 and other stressful situations. Understanding predictors of vaccination, particularly when vaccine hesitancy is increasing,3 is important to developing public health policies and preventive interventions to increase vaccine uptake.4 We prospectively investigated how maternal experiences predicted vaccination status among infants born during the COVID-19 pandemic. Specifically, we examined the contribution of COVID-19–related health care limitations (eg, prenatal telehealth care, <2 days postpartum hospitalization), perinatal experiences (eg, discrimination, birth satisfaction), COVID-19–related stress,1 and known social determinants of health to vaccination status of infants at 3 to 5 months of age.4

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Article Information

Accepted for Publication: September 17, 2021.

Published Online: November 22, 2021. doi:10.1001/jamapediatrics.2021.4710

Corresponding Author: Heidi Preis, PhD, Department of Psychology, Stony Brook University, Stony Brook, NY 11794 (heidi.preis@stonybrook.edu).

Author Contributions: Dr Preis had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Preis, Lobel, Mahaffey.

Drafting of the manuscript: Preis.

Critical revision of the manuscript for important intellectual content: Lobel, Mahaffey, Pati.

Statistical analysis: Preis.

Obtained funding: Preis, Lobel, Mahaffey.

Administrative, technical, or material support: Preis, Lobel.

Supervision: Lobel, Mahaffey.

Conflict of Interest Disclosures: Drs Preis, Lobel, and Mahaffey reported a grant from Stony Brook University Office of the Vice President for Research and Institute for Engineering-Driven Medicine. Drs Preis and Lobel reported a grant from the National Institutes of Health/National Institute on Drug Abuse. Drs Lobel and Mahaffey reported a grant from the State University of New York. Dr Mahaffey reported a grant from the National Institutes of Health/Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr Pati reported a patent for the Keeping Families Healthy Orientation Guide (TXu 2-021-713) issued by Stony Brook University, Department of Pediatrics; is a co-investigator for a grant funded by the Klingenstein Third Generation Foundation; and is an external advisor to McKinsey and Company.

Funding/Support: Funding for this study was provided by a Stony Brook University Office of the Vice President for Research and Institute for Engineering-Driven Medicine COVID-19 seed grant. Dr Preis received support from the National Institutes of Health (grant R21DA049827) during the preparation of this article. Dr Mahaffey received support from the National Institutes of Health (grant K23HD092888) during preparation of this article.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Preis  H , Mahaffey  B , Heiselman  C , Lobel  M .  Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic.   Soc Sci Med. 2020;266:113348. doi:10.1016/j.socscimed.2020.113348PubMedGoogle Scholar
2.
Ackerson  BK , Sy  LS , Glenn  SC ,  et al.  Pediatric vaccination during the COVID-19 pandemic.   Pediatrics. 2021;148(1):e2020047092. doi:10.1542/peds.2020-047092PubMedGoogle Scholar
3.
Sokol  RL , Grummon  AH .  COVID-19 and parent intention to vaccinate their children against influenza.   Pediatrics. 2020;146(6):e2020022871. doi:10.1542/peds.2020-022871PubMedGoogle Scholar
4.
Olusanya  OA , Bednarczyk  RA , Davis  RL , Shaban-Nejad  A .  Addressing parental vaccine hesitancy and other barriers to childhood/adolescent vaccination uptake during the coronavirus (COVID-19) pandemic.   Front Immunol. 2021;12:663074. doi:10.3389/fimmu.2021.663074PubMedGoogle Scholar
5.
Pati  S , Huang  J , Wong  A ,  et al.  Do changes in socio-demographic characteristics impact up-to-date immunization status between 3 and 24 months of age? a prospective study among an inner-city birth cohort in the United States.   Hum Vaccin Immunother. 2017;13(5):1141-1148. doi:10.1080/21645515.2016.1261771PubMedGoogle ScholarCrossref
6.
Schaller  J , Schulkind  L , Shapiro  T .  Disease outbreaks, healthcare utilization, and on-time immunization in the first year of life.   J Health Econ. 2019;67:102212. doi:10.1016/j.jhealeco.2019.05.009PubMedGoogle Scholar
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