PLoS ONE (Jan 2024)

Disparities in COVID-19 vaccine intentions, testing and trusted sources by household language for children with medical complexity.

  • Laura P Chen,
  • Kristina Singh-Verdeflor,
  • Michelle M Kelly,
  • Daniel J Sklansky,
  • Kristin A Shadman,
  • M Bruce Edmonson,
  • Qianqian Zhao,
  • Gregory P DeMuri,
  • Ryan J Coller

DOI
https://doi.org/10.1371/journal.pone.0305553
Journal volume & issue
Vol. 19, no. 6
p. e0305553

Abstract

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ObjectivesChildren with medical complexity experienced health disparities during the coronavirus disease 2019 (COVID-19) pandemic. Language may compound these disparities since people speaking languages other than English (LOE) also experienced worse COVID-19 outcomes. Our objective was to investigate associations between household language for children with medical complexity and caregiver COVID-19 vaccine intentions, testing knowledge, and trusted sources of information.MethodsThis cross-sectional survey of caregivers of children with medical complexity ages 5 to 17 years was conducted from April-June 2022. Children with medical complexity had at least 1 Complex Chronic Condition. Households were considered LOE if they reported speaking any language other than English. Multivariable logistic regression examined associations between LOE and COVID-19 vaccine intentions, interpretation of COVID-19 test results, and trusted sources of information.ResultsWe included 1,338 caregivers of children with medical complexity (49% response rate), of which 133 (10%) had household LOE (31 total languages, 58% being Spanish). There was no association between household LOE and caregiver COVID-19 vaccine intentions. Caregivers in households with LOE had similar interpretations of positive COVID-19 test results, but significantly different interpretations of negative results. Odds of interpreting a negative test as expected (meaning the child does not have COVID-19 now or can still get the virus from others) were lower in LOE households (aOR [95% CI]: 0.56 [0.34-0.95]). Households with LOE were more likely to report trusting the US government to provide COVID-19 information (aOR [95% CI]: 1.86 [1.24-2.81]).ConclusionDifferences in COVID-19 test interpretations based on household language for children with medical complexity were observed and could contribute to disparities in outcomes. Opportunities for more inclusive public health messaging likely exist.