Skip to main content
Top

08-06-2024 | Vaccination | RESEARCH

Coverage and determinants of COVID-19 child vaccination in Munich, Germany in October 2022–January 2023: Results of the COVIP-Virenwächter study

Authors: Sarah van de Berg, Liza Coyer, Ulrich von Both, Theresa Scheuerer, Laura Kolberg, Martin Hoch, Merle M. Böhmer

Published in: European Journal of Pediatrics

Login to get access

Abstract

COVID-19 vaccination reduces the risk of severe disease, in children as well as adults. We studied COVID-19 vaccination coverage among children, parental COVID-19 vaccination intent for their children and determinants of vaccination among children to inform communication strategies. We invited parents of children aged 6 months–11 years in Munich, Germany, to an anonymous online survey between 13.10.2022 and 15.01.2023. Parents reported COVID-19 vaccination status and, for unvaccinated children, vaccination intent per child. We determined vaccination coverage (≥ 1 dose) and parental intent, and subsequently used logistic regression to identify determinants of vaccination, including the 5C psychological antecedents of vaccination (confidence, complacency, constraints, calculation, collective responsibility). In total, 339 parents reported on 591 children. Vaccination coverage was 7% (6/86) amongst 6-months–4-year-olds and 59% (295/498) amongst 5–11-year-olds. For unvaccinated 6-months–4-year-olds, 31% of parents reported high, 13% medium, 56% low vaccination intent; for 5–11-year-olds 8% reported high, 20% medium, 71% low intent. Positive determinants of vaccination were older child age, child belonging to a clinically vulnerable group, as well as parental COVID-19 vaccination, higher education level, country of birth Germany, and high level of trust in official guidelines; a negative determinant was previous vaccination refusal. For 5–11-year-olds, additional positive determinants were higher confidence and lower complacency.
    Conclusion: While a substantial proportion of 5–11-year-olds were vaccinated against COVID-19, coverage was low among 6-months–4-year-olds. Parental vaccination intent for unvaccinated children was low. Vaccination communication should take into account parental socio-demographic characteristics and specifically address individual risks and benefits of child vaccination.
What is Known:
• COVID-19 vaccination lowers severe disease risk in all ages.
• Germany recommends vaccination for 5–11-years-olds since December 2021 and for 6 months–4 year-olds since November 2022.
What is New:
• In Munich, vaccine uptake was high in 5–11-year-olds but parental intent for not yet vaccinated children was low; the opposite was the case for 6-months–4-year-olds; vaccination determinants were eligibility, parental education, birth country and general vaccination hesitancy; psychological antecedents were confidence and complacency.
• Tailored interventions should address guidelines, health literacy, cultural sensitivity, and boost confidence in vaccines and institutions while raising awareness of COVID-19 risks for children.
Appendix
Available only for authorised users
Literature
1.
go back to reference Flaxman S et al (2023) Assessment of COVID-19 as the underlying cause of death among children and young people aged 0 to 19 years in the US. JAMA Netw Open 6(1):e2253590CrossRefPubMedPubMedCentral Flaxman S et al (2023) Assessment of COVID-19 as the underlying cause of death among children and young people aged 0 to 19 years in the US. JAMA Netw Open 6(1):e2253590CrossRefPubMedPubMedCentral
2.
3.
go back to reference Sorg AL et al (2022) Risk for severe outcomes of COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany. Eur J Pediatr 181(10):3635–3643CrossRefPubMedPubMedCentral Sorg AL et al (2022) Risk for severe outcomes of COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany. Eur J Pediatr 181(10):3635–3643CrossRefPubMedPubMedCentral
4.
go back to reference Harwood R et al (2022) Which children and young people are at higher risk of severe disease and death after hospitalisation with SARS-CoV-2 infection in children and young people: a systematic review and individual patient meta-analysis. EClinicalMedicine 44:101287CrossRefPubMedPubMedCentral Harwood R et al (2022) Which children and young people are at higher risk of severe disease and death after hospitalisation with SARS-CoV-2 infection in children and young people: a systematic review and individual patient meta-analysis. EClinicalMedicine 44:101287CrossRefPubMedPubMedCentral
5.
go back to reference Jiang L et al (2022) Epidemiology, clinical features, and outcomes of multisystem inflammatory syndrome in children (MIS-C) and adolescents-a live systematic review and meta-analysis. Curr Pediatr Rep 10(2):19–30CrossRefPubMedPubMedCentral Jiang L et al (2022) Epidemiology, clinical features, and outcomes of multisystem inflammatory syndrome in children (MIS-C) and adolescents-a live systematic review and meta-analysis. Curr Pediatr Rep 10(2):19–30CrossRefPubMedPubMedCentral
6.
go back to reference Zheng YB et al (2023) Prevalence and risk factor for long COVID in children and adolescents: A meta-analysis and systematic review. J Infect Public Health 16(5):660–672CrossRefPubMedPubMedCentral Zheng YB et al (2023) Prevalence and risk factor for long COVID in children and adolescents: A meta-analysis and systematic review. J Infect Public Health 16(5):660–672CrossRefPubMedPubMedCentral
8.
go back to reference Rahmati M et al (2023) New-onset type 1 diabetes in children and adolescents as postacute sequelae of SARS-CoV-2 infection: a systematic review and meta-analysis of cohort studies. J Med Virol 95(6):e28833CrossRefPubMed Rahmati M et al (2023) New-onset type 1 diabetes in children and adolescents as postacute sequelae of SARS-CoV-2 infection: a systematic review and meta-analysis of cohort studies. J Med Virol 95(6):e28833CrossRefPubMed
9.
go back to reference Ständige Impfkommission beim Robert Koch-Institut (2023) Wissenschaftliche Begründung der STIKO zur Implementierung der COVID-19-Impfung in die allgemeinen Empfehlungen der STIKO. Epidemiologisches Bulletin, p 21 Ständige Impfkommission beim Robert Koch-Institut (2023) Wissenschaftliche Begründung der STIKO zur Implementierung der COVID-19-Impfung in die allgemeinen Empfehlungen der STIKO. Epidemiologisches Bulletin, p 21
11.
go back to reference Gao et al (2023) Immunogenicity, effectiveness, and safety of COVID-19 vaccines among children and adolescents aged 2–18 years: an updated systematic review and meta-analysis. World J Pediatr 19(11):1041–1054CrossRefPubMed Gao et al (2023) Immunogenicity, effectiveness, and safety of COVID-19 vaccines among children and adolescents aged 2–18 years: an updated systematic review and meta-analysis. World J Pediatr 19(11):1041–1054CrossRefPubMed
12.
go back to reference Ständige Impfkommission beim Robert Koch-Institut (2022) Beschluss der STIKO zur 15. Aktualisierung der COVID-19-Impfempfehlung. p 1 Ständige Impfkommission beim Robert Koch-Institut (2022) Beschluss der STIKO zur 15. Aktualisierung der COVID-19-Impfempfehlung. p 1
13.
go back to reference Ständige Impfkommission beim Robert Koch-Institut (2022) Beschluss der STIKO zur 20. Aktualisierung der COVID-19-Impfempfehlung. p 21 Ständige Impfkommission beim Robert Koch-Institut (2022) Beschluss der STIKO zur 20. Aktualisierung der COVID-19-Impfempfehlung. p 21
14.
go back to reference Ständige Impfkommission beim Robert Koch-Institut (2022) Beschluss der STIKO zur 23. Aktualisierung der COVID-19-Impfempfehlung. p 46 Ständige Impfkommission beim Robert Koch-Institut (2022) Beschluss der STIKO zur 23. Aktualisierung der COVID-19-Impfempfehlung. p 46
15.
go back to reference Ständige Impfkommission beim Robert Koch-Institut (2023) Implementierung der COVID-19-Impfung in die allgemeinen Empfehlungen der STIKO 2023 (Aktualisierung Epid Bull 4/2023). Epidemiologisches Bulletin 2023:21 Ständige Impfkommission beim Robert Koch-Institut (2023) Implementierung der COVID-19-Impfung in die allgemeinen Empfehlungen der STIKO 2023 (Aktualisierung Epid Bull 4/2023). Epidemiologisches Bulletin 2023:21
17.
go back to reference Brandstetter S et al (2021) Parents’ intention to get vaccinated and to have their child vaccinated against COVID-19: cross-sectional analyses using data from the KUNO-Kids health study. Eur J Pediatr 180(11):3405–3410CrossRefPubMedPubMedCentral Brandstetter S et al (2021) Parents’ intention to get vaccinated and to have their child vaccinated against COVID-19: cross-sectional analyses using data from the KUNO-Kids health study. Eur J Pediatr 180(11):3405–3410CrossRefPubMedPubMedCentral
18.
go back to reference Alimoradi Z, Lin CY, Pakpour AH (2023) Worldwide estimation of parental acceptance of COVID-19 vaccine for their children: a systematic review and meta-analysis. Vaccines (Basel) 11(3):533CrossRefPubMed Alimoradi Z, Lin CY, Pakpour AH (2023) Worldwide estimation of parental acceptance of COVID-19 vaccine for their children: a systematic review and meta-analysis. Vaccines (Basel) 11(3):533CrossRefPubMed
19.
go back to reference Vogel S et al (2022) SARS-CoV-2 saliva mass screening in primary schools: a 10-week sentinel surveillance study in Munich, Germany. Diagnostics (Basel) 12(1):162CrossRefPubMed Vogel S et al (2022) SARS-CoV-2 saliva mass screening in primary schools: a 10-week sentinel surveillance study in Munich, Germany. Diagnostics (Basel) 12(1):162CrossRefPubMed
20.
go back to reference Piechotta V et al (2022) STIKO: 20. Aktualisierung der COVID-19-Impfempfehlung. Epidemiol Bull 21:4–19 Piechotta V et al (2022) STIKO: 20. Aktualisierung der COVID-19-Impfempfehlung. Epidemiol Bull 21:4–19
22.
go back to reference Galanis et al (2022) Willingness, refusal and influential factors of parents to vaccinate their children against the COVID-19: A systematic review and meta-analysis. Prev Med 157:106994CrossRefPubMedPubMedCentral Galanis et al (2022) Willingness, refusal and influential factors of parents to vaccinate their children against the COVID-19: A systematic review and meta-analysis. Prev Med 157:106994CrossRefPubMedPubMedCentral
23.
go back to reference Jongen VW et al (2021) Human papillomavirus vaccination uptake: a longitudinal study showing ethnic differences in the influence of the intention-to-vaccinate among parent-daughter dyads. Hum Vaccin Immunother 17(4):990–999CrossRefPubMed Jongen VW et al (2021) Human papillomavirus vaccination uptake: a longitudinal study showing ethnic differences in the influence of the intention-to-vaccinate among parent-daughter dyads. Hum Vaccin Immunother 17(4):990–999CrossRefPubMed
24.
26.
go back to reference Wickham H et al (2019) Welcome to the tidyverse. J Open Source Softw 4(43):1686CrossRef Wickham H et al (2019) Welcome to the tidyverse. J Open Source Softw 4(43):1686CrossRef
27.
go back to reference Halekoh U, Højsgaard S, Yan J (2006) The R package geepack for generalized estimating equations. J Stat Softw 15(2):1–11CrossRef Halekoh U, Højsgaard S, Yan J (2006) The R package geepack for generalized estimating equations. J Stat Softw 15(2):1–11CrossRef
28.
go back to reference Hoshen M et al (2022) How to increase COVID-19 vaccine uptake among children? determinants associated with vaccine compliance. Front Pediatr 10:1038308CrossRefPubMed Hoshen M et al (2022) How to increase COVID-19 vaccine uptake among children? determinants associated with vaccine compliance. Front Pediatr 10:1038308CrossRefPubMed
29.
go back to reference Khatatbeh M et al (2022) Children’s rates of COVID-19 vaccination as reported by parents, vaccine hesitancy, and determinants of COVID-19 vaccine uptake among children: a multi-country study from the Eastern Mediterranean Region. BMC Public Health 22(1):1375CrossRefPubMedPubMedCentral Khatatbeh M et al (2022) Children’s rates of COVID-19 vaccination as reported by parents, vaccine hesitancy, and determinants of COVID-19 vaccine uptake among children: a multi-country study from the Eastern Mediterranean Region. BMC Public Health 22(1):1375CrossRefPubMedPubMedCentral
30.
go back to reference Singh GK, Lee H, Azuine RE (2022) Marked disparities in COVID-19 vaccination among US children and adolescents by racial/ethnic, socioeconomic, geographic, and health characteristics, United States, December 2021 - April 2022. Int J MCH AIDS 11(2):e598CrossRefPubMedPubMedCentral Singh GK, Lee H, Azuine RE (2022) Marked disparities in COVID-19 vaccination among US children and adolescents by racial/ethnic, socioeconomic, geographic, and health characteristics, United States, December 2021 - April 2022. Int J MCH AIDS 11(2):e598CrossRefPubMedPubMedCentral
31.
go back to reference Nguyen KH et al (2022) Child and adolescent COVID-19 vaccination status and reasons for non-vaccination by parental vaccination status. Public Health 209:82–89CrossRefPubMed Nguyen KH et al (2022) Child and adolescent COVID-19 vaccination status and reasons for non-vaccination by parental vaccination status. Public Health 209:82–89CrossRefPubMed
32.
go back to reference Batzella E et al (2023) The association between pediatric COVID-19 vaccination and socioeconomic position: nested case-control study from the Pedianet Veneto Cohort. JMIR Public Health Surveill 9:e44234CrossRefPubMedPubMedCentral Batzella E et al (2023) The association between pediatric COVID-19 vaccination and socioeconomic position: nested case-control study from the Pedianet Veneto Cohort. JMIR Public Health Surveill 9:e44234CrossRefPubMedPubMedCentral
33.
go back to reference Bardosh K et al (2022) The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good. BMJ Glob Health 7(5):e008684CrossRefPubMed Bardosh K et al (2022) The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good. BMJ Glob Health 7(5):e008684CrossRefPubMed
34.
go back to reference Rane MS et al (2022) Intention to vaccinate children against COVID-19 among vaccinated and unvaccinated US parents. JAMA Pediatr 176(2):201–203CrossRefPubMed Rane MS et al (2022) Intention to vaccinate children against COVID-19 among vaccinated and unvaccinated US parents. JAMA Pediatr 176(2):201–203CrossRefPubMed
35.
go back to reference Crawshaw AF et al (2022) Defining the determinants of vaccine uptake and undervaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: a systematic review. Lancet Infect Dis 22(9):e254–e266CrossRefPubMedPubMedCentral Crawshaw AF et al (2022) Defining the determinants of vaccine uptake and undervaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: a systematic review. Lancet Infect Dis 22(9):e254–e266CrossRefPubMedPubMedCentral
36.
go back to reference Shen AK et al (2022) Factors influencing parental and individual COVID-19 vaccine decision making in a pediatric network. Vaccines (Basel) 10(8):1277CrossRefPubMed Shen AK et al (2022) Factors influencing parental and individual COVID-19 vaccine decision making in a pediatric network. Vaccines (Basel) 10(8):1277CrossRefPubMed
37.
go back to reference Steletou E et al (2022) Parental and pediatricians’ attitudes towards COVID-19 vaccination for children: results from nationwide samples in Greece. Children (Basel) 9(8):1211PubMed Steletou E et al (2022) Parental and pediatricians’ attitudes towards COVID-19 vaccination for children: results from nationwide samples in Greece. Children (Basel) 9(8):1211PubMed
38.
go back to reference Betsch C et al (2019) Psychological antecedents of vaccination: definitions, measurement, and interventions. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 62(4):400–409CrossRefPubMed Betsch C et al (2019) Psychological antecedents of vaccination: definitions, measurement, and interventions. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 62(4):400–409CrossRefPubMed
39.
go back to reference O’Leary ST et al (2024) Strategies for improving vaccine communication and uptake. Pediatrics 153(3):e2023065483CrossRefPubMed O’Leary ST et al (2024) Strategies for improving vaccine communication and uptake. Pediatrics 153(3):e2023065483CrossRefPubMed
40.
go back to reference Alenezi S et al (2022) Parental perceptions and the 5C psychological antecedents of COVID-19 vaccination during the first month of omicron variant surge: A large-scale cross-sectional survey in Saudi Arabia. Front Pediatr 10:944165CrossRefPubMedPubMedCentral Alenezi S et al (2022) Parental perceptions and the 5C psychological antecedents of COVID-19 vaccination during the first month of omicron variant surge: A large-scale cross-sectional survey in Saudi Arabia. Front Pediatr 10:944165CrossRefPubMedPubMedCentral
41.
go back to reference Wagner A et al (2022) Confident and altruistic - parents’ motives to vaccinate their children against COVID-19: a cross-sectional online survey in a Swiss vaccination centre. Swiss Med Wkly 152:w30156CrossRefPubMed Wagner A et al (2022) Confident and altruistic - parents’ motives to vaccinate their children against COVID-19: a cross-sectional online survey in a Swiss vaccination centre. Swiss Med Wkly 152:w30156CrossRefPubMed
44.
go back to reference Sokol RL, Grummon AH (2020) COVID-19 and parent intention to vaccinate their children against influenza. Pediatrics 146(6):e2020022871CrossRefPubMed Sokol RL, Grummon AH (2020) COVID-19 and parent intention to vaccinate their children against influenza. Pediatrics 146(6):e2020022871CrossRefPubMed
Metadata
Title
Coverage and determinants of COVID-19 child vaccination in Munich, Germany in October 2022–January 2023: Results of the COVIP-Virenwächter study
Authors
Sarah van de Berg
Liza Coyer
Ulrich von Both
Theresa Scheuerer
Laura Kolberg
Martin Hoch
Merle M. Böhmer
Publication date
08-06-2024
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Pediatrics
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-024-05617-0