LAUSR

Understanding the role of vaccine hesitancy in under-vaccination or non-vaccination of childhood vaccines is important for increasing vaccine confidence and uptake. We used data from April to June interviews in the 2018 and 2019 National Immunization Survey-Flu (n=78,725), a nationally representative cross-sectional household cellular telephone survey. We determined the adjusted population attributable fraction (PAF) for each recommended childhood vaccine to assess the contribution of vaccine hesitancy to the observed non-vaccination level. Hesitancy is defined as being somewhat or very hesitant toward childhood vaccines. Furthermore, we assessed the PAF of non-vaccination for influenza by sociodemographic characteristics, Health and Human Services region, and state. The proportion of non-vaccination attributed to parental vaccine hesitancy was lowest for hepatitis B birth dose vaccine (6.5%) and highest for ≥3 dose diphtheria and tetanus toxoids, and acellular pertussis vaccine (31.3%). The PAF of non-vaccination on influenza non-vaccination was highest for non-Hispanic White and Black populations (15.4%), households with high educational (17.7%) and income levels (16.5%), and urban areas (16.1%). Among states, PAF ranged from 25.4% (New Hampshire) to 7.5% (Louisiana). Implementing strategies to increase vaccination confidence and uptake are important, particularly during the COVID-19 pandemic.