Using Digital Technology to Build COVID-19 Vaccine Confidence: A Qualitative Study among Latinx Parents of Children Aged 5-11 in Under-Resourced Communities across Los Angeles County.

Background: Latinx school-aged children are more than twice as likely to be infected with and die from COVID-19 as non-Latinx White children in Los Angeles. Although COVID-19 vaccination has the potential to mitigate health disparities exacerbated by the pandemic, vaccination uptake among Latinx children remains limited. MiVacunaLA (MVLA) is a mobile-phone-delivered digital intervention that improved vaccination rates in 12- to 17-year-old Latinx children and parental intention to vaccinate 2- to 11-year-old children. Since piloting MVLA, the COVID-19 vaccine became available to children aged 5-11. We sought to understand parental experiences with the MVLA intervention and their attitudes and beliefs about vaccinating their young children to improve vaccination confidence in the Latinx community. Methods: We conducted six virtual focus groups with 47 parents/caregivers of children aged 5-11 who participated in the MVLA intervention. We used standard qualitative content analysis methods and rigid and accelerated data reduction to identify and analyze major themes discussed in the sessions. Results: Each salient theme from our focus groups was mapped to one of the 5Cs constructs. The themes included the parents' need for more contemplation about vaccinating their children than about vaccinating themselves; the parents' need for trusted sources of vaccine information; the parents' motivations to vaccinate their children against COVID-19; parental concern about short- and long-term effects of the vaccine in children; digital technology and videos as useful engagement tools; and age and health stratification as an approach to parental vaccination decision-making. Conclusions: The results of this study clarify the key factors that influence the decision of Latinx parents and caregivers to vaccinate their children against COVID-19. Our findings can inform efforts to increase COVID-19 vaccination rates among children in underserved Latinx communities, especially regarding the use of digital technologies for promoting vaccine confidence.