Approximately one-quarter of parents lie about their child’s COVID-19 status or don’t follow public health guidelines like quarantines meant to prevent viral spread, according to survey findings published in JAMA Network Open.1
Researchers, led by Andrea Gurmankin Levy, PhD, MBE, used a subset of data from a larger national sample of 1733 US adults to focus on survey responses among 580 parents (mean age, 35.9 years; 67% non-Hispanic White; 70% identified as women) of children younger than 18 years.
In total, 150 parents (25.9%) reported misrepresentation and/or nonadherence in at least 1 of 7 behaviors, the most common of which was not telling someone who was with their child that they thought or knew their child had COVID-19 (24.0%) and allowing their child to break quarantine rules (21.1%). Forty-seven parents (10%) said their child was vaccinated when they were not.
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The top reason cited for these behaviors were wanting to exercise personal freedom. Other key findings are as follows:
• Approximately 60% of parents who lied about their child being vaccinated against COVID-19 did so to allow the child to participate in an activity that required vaccination.
• Nearly 43% of parents said they didn’t tell others that their children had COVID-19 because they didn’t want them to miss school.
• Approximately 35% of parents didn’t disclose their child’s COVID-19 infection because they could not miss work to stay home
“We need to do a better job of providing support mechanisms like paid sick leave for family illness so that parents don’t feel like their only option is to engage in misrepresentation or nonadherence to public health guidelines during a future infectious disease outbreak that matches or exceeds the magnitude of COVID-19,” Dr Levy said.2
The researchers also suggested that health officials need to develop policies and technologies that don’t depend on the honor system or jeopardize privacy to protect public health in the future.
Strategies to educate parents and counter disinformation also are clearly needed, and an online intervention targeted at new parents is one proposed solution.
Vaccine Hesitancy During Pregnancy
Despite decades of scientific studies demonstrating the benefits of prenatal and infant vaccines, many parents question the value of vaccines, especially during pregnancy.3 Separating vaccine facts from disinformation can be challenging for many parents.
To help counter disinformation among new mothers, researchers at NYU Rory Meyers College of Nursing, New York City, initiated a web-based educational program. The program focused on finding reliable health information and the dangers of babies contracting vaccine-preventable illnesses. The program was effective in persuading vaccine-hesitant mothers to vaccinate themselves and their infants, the researchers reported in The Nurse Practitioner.
“Disinformation is a major factor in vaccine hesitancy, which has been very evident throughout the COVID-19 pandemic,” said Donna Hallas, PhD, PPCNP-BC, CPNP, PMHS, FAANP, director of the Pediatric Nurse Practitioner program and a clinical professor at NYU Rory Meyers College of Nursing. “Social media allows disinformation to spread rapidly, stoking fear and mistrust.”4
The study findings also demonstrate the value of an online intervention that reaches people where they are, as the study was conducted online with the exception of in-person recruitment, the researchers noted. “The decision to use all online materials and interventions was based on the knowledge that social media influences decision-making, especially regarding immunization of expectant mothers,” added Dr Hallas.
Web-Based Vaccine Educational Program
The web-based program was designed to develop new mothers’ abilities to recognize vaccine disinformation on social media platforms and antivax websites, educate them about the consequences of vaccine-preventable illnesses, and make informed decisions. Vaccine-hesitant pregnant women and mothers were shown videos and educated on how to seek out trustworthy information and avoid disinformation. Participants who were still hesitant about vaccines watched a brief video by a parent of an infant in the pediatric ICU sick with either influenza or pertussis, highlighting that the baby had a vaccine-preventable illness.
The study was conducted in 2018 and 2019, prior to the COVID-19 pandemic, and included 2 groups: 141 pregnant persons who were approached about the study at an Ob/Gyn practice and 124 mothers of newborns recruited in a postpartum hospital unit. The parents completed surveys on their attitudes about vaccines during pregnancy and vaccinating their children. Participants were asked about their immunization behaviors, beliefs about vaccine safety and efficacy, attitudes about vaccine mandates and exemptions, and trust in health care providers and information they receive.
Participants who readily accepted vaccines were assigned to the study’s control groups, while those who were hesitant about vaccines were placed into the intervention groups to take part in the online program. Those who refused vaccines completely were not included in the study, but the researchers are planning future studies focused on educating this subgroup.
Intervention Improves Vaccination Rate Among Hesitant Mothers
After the intervention, the researchers viewed participants’ medical records to see whether pregnant women received vaccines during pregnancy (influenza and Tdap) and whether mothers to newborns vaccinated their babies with the hepatitis B vaccine and other vaccines on the Centers for Disease Control and Prevention (CDC) immunization schedule for 2-, 4-, and 6-month well-visits.
Among pregnant women who were initially unsure or hesitant about vaccination, 82% received both flu and Tdap vaccines during pregnancy after the online intervention. The majority (74%) of all mothers of newborns fully immunized their infants, however, this data is limited by the large group of babies for whom vaccine data was not available.
“Showing vaccine-hesitant individuals a brief video of how ill a child can become from a vaccine-preventable disease appeared to be an effective strategy to help them make an informed decision,” said Dr Hallas. “No parent wants the first-hand experience of a sick child in the hospital, but this was a reality for many this fall and winter. More than 100 children have died from the flu—a disease against which we have an effective vaccine—and tens of thousands of children were hospitalized with RSV, which may soon have an FDA-approved vaccine. Empowering mothers with skills for vetting health information and showing them the reality of vaccine-preventable diseases can help move them from hesitancy to acceptance.”
Sources
1. Levy AG, Thorpe A, Scherer LD, et al. Parental nonadherence to health policy recommendations for prevention of COVID-19 transmission among children. JAMA Netw Open. 2023;6(3):e231587. doi:10.1001/jamanetworkopen.2023.1587
2. One in four parents misled others about their children having covid-19, survey finds. News release. University of Utah Health. March 2, 2023. https://www.newswise.com/coronavirus/one-in-four-parents-misled-others-about-their-children-having-covid-19-survey-finds/?article_id=787903
3. Hallas D, Altman S, Mandel E, Fletcher J. Vaccine hesitancy in prenatal women and mothers of newborns: results of an interventional study. Nurse Pract. 2023;48(3):36-47.
4. Online program prompts vaccination among vaccine-hesitant mothers. News release. New York University. March 8, 2023. https://www.nyu.edu/about/news-publications/news/2023/march/online-program-prompts-vaccination-among-vaccine-hesitant-mother.html
