Clinical Report: COVID-19 Vaccine Hesitancy in Pediatric Hematopoietic Stem Cell Transplant Recipients

Overview

This study investigates COVID-19 vaccine hesitancy among parents of children who have undergone hematopoietic stem cell transplantation (HCT). It highlights the prevalence of vaccine reluctance in this vulnerable population and explores the impact of the COVID-19 pandemic on parental attitudes toward vaccination.

Background

COVID-19, caused by SARS-CoV-2, has resulted in a global pandemic with significant morbidity and mortality. Vaccination efforts have been prioritized, including approval for adolescents and children aged 5–11 years. Hematopoietic stem cell transplant recipients are at high risk for severe COVID-19 and are recommended to receive vaccination post-transplant, although immune response may be suboptimal. Vaccine hesitancy remains a major barrier to achieving adequate vaccination coverage, particularly in vulnerable populations such as pediatric HCT recipients.

Data Highlights

The study recruited parents of children aged 0 to ≤17 years with a history of HCT via online and local clinical methods. Data collected included demographics, COVID-19 exposure, family impact scores, and vaccine hesitancy assessments. The COVID-19 Exposure and Family Impact Scale (CEFIS) measured pandemic-related distress, while a modified Vaccine Hesitancy Questionnaire (VHS) assessed parental reluctance to vaccinate their children against COVID-19.

Key Findings

• Parents of pediatric HCT recipients exhibit notable COVID-19 vaccine hesitancy, influenced by concerns about vaccine safety and efficacy in immunocompromised children.
• The COVID-19 pandemic has had a significant negative impact on families, with increased parental and child distress correlating with vaccine hesitancy.
• Recruitment via social media and clinical settings allowed for diverse participant inclusion, capturing hesitancy before and after vaccine approval for adolescents.
• Vaccine hesitancy rates in this population are consistent with or higher than those reported in other pediatric cancer survivor groups and adult cancer patients.
• Understanding specific factors contributing to hesitancy is critical to developing targeted interventions to improve vaccine uptake in this high-risk group.

Clinical Implications

Clinicians should be aware of the high prevalence of COVID-19 vaccine hesitancy among parents of pediatric HCT recipients and proactively address concerns regarding vaccine safety and efficacy. Tailored communication strategies and supportive counseling may help mitigate hesitancy and improve vaccination rates. Monitoring pandemic-related distress may also inform holistic care approaches to support families during this period.

Conclusion

This study underscores the importance of addressing COVID-19 vaccine hesitancy in parents of children post-hematopoietic stem cell transplant. Targeted interventions are needed to enhance vaccine acceptance and protect this vulnerable population from COVID-19 complications.

References

1. WHO 2020 -- COVID-19 Declared a Pandemic
2. CDC 2021 -- COVID-19 Vaccine Recommendations for Immunocompromised Individuals
3. Kempe et al. -- Vaccine Hesitancy Questionnaire Development
4. American Society of Hematology and ASTCT 2021 -- COVID-19 Vaccine Guidance for HCT Recipients