Background/Purpose: The U.S. FDA has expanded the emergency use authorization of the COVID-19 vaccine to include children >12 years of age. Gaining an understanding of the acceptability of a COVID-19 vaccine among children with autoimmune diseases may help rheumatologists to develop resources and best practices for shared decision making when offering the COVID-19 vaccine to their patients.

The objective of this study is to evaluate the knowledge and perceptions regarding COVID-19 vaccination and determine the self-reported likelihood of receiving a hypothetical COVID-19 vaccine among children with rheumatic diseases.

Methods: We surveyed a convenience sample of 54 children seen in our pediatric rheumatology clinic in May 2021 to estimate the respondents’ perceptions regarding the COVID-19 vaccine. Respondents were asked questions to assess their knowledge about COVID-19 and willingness to accept the COVID-19 vaccine.

Results: Of the 54 patients surveyed, the median age of the participants was 12.9 (range 5-18) years and 78% were females. Racial/ethnic minorities contributed about 52% among the respondents. Forty percent of the respondents had juvenile idiopathic arthritis.

Regarding knowledge about COVID-19 disease, 83% agreed with the statement that COVID-19 was caused by a virus but 20% “agreed” or “strongly agreed” with the statement that influenza and COVID-19 were caused by the same virus. Twenty-one percent of respondents perceived that COVID-19 patients were symptomatic, sick, and required hospitalization. Our respondents gathered information about the pandemic from social media (45%) and television (50%). Sixty-eight percent of patients discussed COVID-19 and its implications with their doctor.

Regarding perceptions about the vaccine, 82% of respondents “strongly agreed” or “agreed” with the statement, “There is misinformation regarding COVID-19 vaccine on the internet”. Greater than 75% of our respondents practiced social distancing, hand hygiene and wore masks in public spaces. Although 55% of our respondent reported willingness to accept a COVID-19 vaccine, only 39% perceived that the vaccine would provide protection from the disease and 85% stated concerns about side effects. Respondents cited greater concerns about vaccine side effects when compared to disease complications (40%).

We found that the acceptability of the COVID-19 vaccine was higher among whites when compared to racial/ethnic minorities (84% vs. 58%). Similarly, concerns about side effects and was higher among racial/ethnic minorities. Willingness to pay for the vaccine was also lower among racial/ethnic minorities.

Conclusion: Our study identifies the specific knowledge gaps and incorrect perceptions about COVID-19 and the COVID-19 vaccine among children with rheumatic diseases. Concerns about the effectiveness of the vaccine and potential side effects were high. We found that self-reported likelihood of vaccine acceptability was lower among racial/ethnic minorities when compared to whites. The results of this survey study may help inform public health campaigns to address COVID-19 vaccine hesitancy among these special populations.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/acceptability-of-covid-19-vaccine-among-pediatric-rheumatology-patients-in-californias-central-valley/