Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee

Introduction: The COVID-19 pandemic disrupted routine childhood vaccinations schedules, posing significant challenges among underserved communities. Understanding how different sociodemographic groups in Tennessee perceive and navigate childhood vaccination barriers is critical for developing strate...

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Main Authors: Sanjaya Regmi, Elizabeth Sowell, Chenoa D. Allen, Benjamin E. Jones, Nan M. Gaylord, Victoria Niederhauser
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/13/5/452
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author Sanjaya Regmi
Elizabeth Sowell
Chenoa D. Allen
Benjamin E. Jones
Nan M. Gaylord
Victoria Niederhauser
author_facet Sanjaya Regmi
Elizabeth Sowell
Chenoa D. Allen
Benjamin E. Jones
Nan M. Gaylord
Victoria Niederhauser
author_sort Sanjaya Regmi
collection DOAJ
description Introduction: The COVID-19 pandemic disrupted routine childhood vaccinations schedules, posing significant challenges among underserved communities. Understanding how different sociodemographic groups in Tennessee perceive and navigate childhood vaccination barriers is critical for developing strategies to improve vaccination rates and reduce vulnerability to vaccine-preventable diseases. Methods: A cross-sectional survey was conducted to explore barriers to vaccination across diverse sociodemographic groups in Tennessee. Data were collected from caregivers/parents of children aged 18 years and younger across all 95 counties in Tennessee at community events and through partnerships with schools and other local organizations. Parental responses were analyzed to identify barriers in access, concern, and importance domains. The distribution of barriers across different sociodemographic groups such as race, income, education level, and insurance status was identified. Descriptive statistics, non-parametric tests, and log-binomial regressions were used to address the research objectives. Results: This study found that the most prominent barriers to childhood vaccination were concerns regarding vaccine safety and side effects. Significant differences in vaccine barriers were observed across racial and ethnic groups for access barriers (<i>p</i> < 0.001), concern barriers (<i>p</i> = 0.006), and importance barriers (<i>p</i> < 0.001). Parents with lower education levels, children without health insurance, and lower-income families faced disproportionate challenges across two of the three barrier domains studied (access and perceived importance of vaccines). Additionally, concern barriers (aPR = 0.998, <i>p</i> < 0.001) and importance barriers (aPR = 0.997, <i>p</i> < 0.001) were strongly associated with the parent-reported prevalence of up-to-date vaccination status. Conclusions: Addressing parental vaccination barriers related to concern, access, and perceived importance is crucial, particularly for underserved populations including low-income families, uninsured parents, racial/ethnic minorities, and those with limited education. A sustained, equity-focused approach integrating scientific communication, community engagement, and policy interventions is essential for increasing vaccine uptake and ensuring equitable vaccination access.
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spelling doaj-art-e70797e2937c4f0fa99a0ac7c0b4b8d52025-08-20T03:48:01ZengMDPI AGVaccines2076-393X2025-04-0113545210.3390/vaccines13050452Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in TennesseeSanjaya Regmi0Elizabeth Sowell1Chenoa D. Allen2Benjamin E. Jones3Nan M. Gaylord4Victoria Niederhauser5College of Nursing, The University of Tennessee, Knoxville, TN 37996, USACollege of Nursing, The University of Tennessee, Knoxville, TN 37996, USASocial Work Office of Research and Public Service, The University of Tennessee, Knoxville, TN 37996, USACollege of Nursing, The University of Tennessee, Knoxville, TN 37996, USACollege of Nursing, The University of Tennessee, Knoxville, TN 37996, USACollege of Nursing, The University of Tennessee, Knoxville, TN 37996, USAIntroduction: The COVID-19 pandemic disrupted routine childhood vaccinations schedules, posing significant challenges among underserved communities. Understanding how different sociodemographic groups in Tennessee perceive and navigate childhood vaccination barriers is critical for developing strategies to improve vaccination rates and reduce vulnerability to vaccine-preventable diseases. Methods: A cross-sectional survey was conducted to explore barriers to vaccination across diverse sociodemographic groups in Tennessee. Data were collected from caregivers/parents of children aged 18 years and younger across all 95 counties in Tennessee at community events and through partnerships with schools and other local organizations. Parental responses were analyzed to identify barriers in access, concern, and importance domains. The distribution of barriers across different sociodemographic groups such as race, income, education level, and insurance status was identified. Descriptive statistics, non-parametric tests, and log-binomial regressions were used to address the research objectives. Results: This study found that the most prominent barriers to childhood vaccination were concerns regarding vaccine safety and side effects. Significant differences in vaccine barriers were observed across racial and ethnic groups for access barriers (<i>p</i> < 0.001), concern barriers (<i>p</i> = 0.006), and importance barriers (<i>p</i> < 0.001). Parents with lower education levels, children without health insurance, and lower-income families faced disproportionate challenges across two of the three barrier domains studied (access and perceived importance of vaccines). Additionally, concern barriers (aPR = 0.998, <i>p</i> < 0.001) and importance barriers (aPR = 0.997, <i>p</i> < 0.001) were strongly associated with the parent-reported prevalence of up-to-date vaccination status. Conclusions: Addressing parental vaccination barriers related to concern, access, and perceived importance is crucial, particularly for underserved populations including low-income families, uninsured parents, racial/ethnic minorities, and those with limited education. A sustained, equity-focused approach integrating scientific communication, community engagement, and policy interventions is essential for increasing vaccine uptake and ensuring equitable vaccination access.https://www.mdpi.com/2076-393X/13/5/452vaccination barrierschildhood immunizationvaccine hesitancyvaccine concernsCOVID-19vaccine disparities
spellingShingle Sanjaya Regmi
Elizabeth Sowell
Chenoa D. Allen
Benjamin E. Jones
Nan M. Gaylord
Victoria Niederhauser
Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee
Vaccines
vaccination barriers
childhood immunization
vaccine hesitancy
vaccine concerns
COVID-19
vaccine disparities
title Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee
title_full Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee
title_fullStr Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee
title_full_unstemmed Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee
title_short Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee
title_sort parental barriers and sociodemographic disparities in childhood vaccination post covid 19 in tennessee
topic vaccination barriers
childhood immunization
vaccine hesitancy
vaccine concerns
COVID-19
vaccine disparities
url https://www.mdpi.com/2076-393X/13/5/452
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