Original article
Parent and Peer Norms are Unique Correlates of COVID-19 Vaccine Intentions in a Diverse Sample of U.S. Adolescents

https://doi.org/10.1016/j.jadohealth.2021.09.012Get rights and content

Abstract

Purpose

Recent studies have documented worrisome levels of hesitancy and resistance to the COVID-19 vaccine, including within the adolescent population. In this study, we examined attitudinal (perceived severity of COVID-19, vaccine-related concerns) and interpersonal (parent and peer norms) antecedents of adolescents' intentions to receive the COVID-19 vaccine.

Methods

Participants were 916 adolescents (aged 12–17 years) from across the United States (47.3% male) representing diverse ethnic and socioeconomic backgrounds (26% African-American, 22% Hispanic/Latinx, 35% white, 7% Asian American). They completed a survey on their experiences and attitudes surrounding COVID-19 and the COVID-19 vaccine.

Results

Parent and peer norms were distinct predictors of adolescent willingness to receive the vaccine. These norms were associated with vaccine intentions directly and indirectly through adolescents' beliefs about the vaccine's safety, efficacy, and necessity. Parent norms in particular displayed large effect sizes and explained considerable variance in adolescents' vaccine intentions.

Conclusions

Parents and friends—who figure as adolescents' most salient interpersonal relationships—are key leveraging points in promoting adolescents' uptake of the COVID-19 vaccine. Norm interventions and family-based interventions may be successful in this regard.

Section snippets

Antecedents of COVID-19 Vaccination Intentions

The HBM [2] and supporting literature [3,4] hold that the most proximal determinants of an individual's uptake of a vaccine include (a) their perceived severity of and susceptibility to the disease, alongside (b) their perceived benefits and/or risks of receiving the vaccine. Adolescents report various perceptions and anxieties regarding the severity of COVID-19 and its impact on their lives, including worries about their health, changes in their peer networks and family dynamics, increased

Participants and procedures

Between 10 June and 24 June 2021, participants were recruited from a third-party research service, Qualtrics, which retains a national database of research participants gathered through various digital advertising channels (e.g., social media, search engines) and address-based sampling methods (e.g., mailing lists). A stratified random sample of adolescents was drawn from this database, using national quotas for adolescent age, gender, parent income, and U.S. geographic region (south, west,

Results

Participants were 916 adolescents from across the United States, ranging in age from 12 to 17 years (Mage = 14.69, standard deviation = 1.69) and representing diverse racial/ethnic, socioeconomic, and geographic backgrounds (see Table 1 for sample characteristics; see Table S2 of online supplemental material for vaccination intentions by sample characteristics).

Discussion

Adolescents are now a focus in the COVID-19 vaccination effort, but little is known about the antecedents of their intentions to be vaccinated. We examined attitudinal and interpersonal antecedents of adolescents' intentions to receive a COVID-19 vaccine, including the direct and indirect pathways characterizing these associations. Specifically, we examined the impact and perceived threat of the pandemic, concerns about the vaccine's safety and necessity, and parent and peer norms surrounding

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of interest: The authors declare no conflicts of interest.

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