Impact of a hypothetical COVID-19 vaccine mandate on parental likelihood to vaccinate children: Exploring school-related concerns and vaccination decision-making.

OBJECTIVE: We assessed the impact of a hypothetical school-entry COVID-19 vaccine mandate on parental likelihood to vaccinate their child. METHODS: We collected demographics, COVID-19-related school concerns, and parental likelihood to vaccinate their child from parents of patients aged 3-16 years seen across nine pediatric Emergency Departments from 06/07/2021 to 08/13/2021. Wilcoxon signed-rank test compared pre- and post-mandate vaccination likelihood. Multivariate linear and logistic regression analyses explored associations between parental concerns with baseline and change in vaccination likelihood, respectively. RESULTS: Vaccination likelihood increased from 43% to 50% with a hypothetical vaccine mandate (Z = -6.69, p < 0.001), although most parents (63%) had no change, while 26% increased and 11% decreased their vaccination likelihood. Parent concerns about their child contracting COVID-19 was associated with greater baseline vaccination likelihood. No single school-related concern explained the increased vaccination likelihood with a mandate. CONCLUSION: Parental school-related concerns did not drive changes in likelihood to vaccinate with a mandate.

Factors Associated With Parental Acceptance of COVID-19 Vaccination: A Multicenter Pediatric Emergency Department Cross-Sectional Analysis.

STUDY OBJECTIVE: During the delta surge of the COVID-19 pandemic in 2021, we sought to identify characteristics and beliefs associated with COVID-19 vaccination acceptance in parents of pediatric emergency department (ED) patients. METHODS: We conducted a cross-sectional survey-based study of the parents of children aged 3 to 16 years presenting to 1 of 9 pediatric EDs from June to August 2021 to assess the parental acceptance of COVID-19 vaccines. Using multiple variable regression, we ascertained which factors were associated with parental and pediatric COVID-19 vaccination acceptance. RESULTS: Of 1,491 parents approached, 1,298 (87%) participated, of whom 50% of the parents and 27% of their children aged 12 years or older and older were vaccinated. Characteristics associated with parental COVID-19 vaccination were trust in scientists (adjusted odds ratio [aOR] 5.11, 95% confidence interval [CI] 3.65 to 7.15), recent influenza vaccination (aOR 2.66, 95% CI 1.98 to 3.58), college degree (aOR 1.97, 95% CI 1.36 to 2.85), increasing parental age (aOR 1.80, 95% CI 1.45 to 2.22), a friend or family member hospitalized because of COVID-19 (aOR 1.34, 95% CI 1.05 to 1.72), and higher income (aOR 1.60, 95% CI 1.27 to 2.00). Characteristics associated with pediatric COVID-19 vaccination (children aged ≥12 years) or intended COVID-19 pediatric vaccination, once approved for use, (children aged <12 years) were parental trust in scientists (aOR 5.37, 95% CI 3.65 to 7.88), recent influenza vaccination (aOR 1.89, 95% CI 1.29 to 2.77), trust in the media (aOR 1.68, 95% CI 1.19 to 2.37), parental college degree (aOR 1.49, 95% CI 1.01 to 2.20), and increasing parental age (aOR 1.26, 95% CI 1.01 to 1.57). CONCLUSION: Overall COVID-19 vaccination acceptance was low. Trust in scientists had the strongest association with parental COVID-19 vaccine acceptance for both themselves and their children.

An easy maneuver to screen for moderate-to-severe obstructive sleep spnea: the Simmons Chin Press and Tongue Curl.

OBJECTIVES: To demonstrate that the Simmons chin press and tongue curl (SCPTC) correlates with diagnosis of moderate-to-severe obstructive sleep apnea (msOSA) by itself as well as irrespective of the presence of other associated features. MATERIAL AND METHODS: A consecutive sample of 1,911 sleep studies performed on adult patients from 2/8/2017 to 3/5/2019 was analyzed. The SCPTC exam maneuver was performed on each patient, followed by home sleep apnea testing or in-laboratory polysomnography. The AASM hypopnea 1B 4% desaturation criteria were utilized for scoring to correlate results to existing literature on morbidity and mortality. A chi-squared using low and high SCPTC score was performed for the outcome of msOSA. Known significant predictors of OSA were dichotomized for comparison and a multiple logistic regression was performed. RESULTS: 1,708 patients qualified for inclusion: 902 males (52.8%) and 806 females (47.2%) with a mean age of 49.4 and a mean body mass index (BMI) of 28.6. A high SCPTC score correlated with an odds ratio (OR) of 2.49 (95% CI: 2.03-3.04, p<0.001) for msOSA. A multiple logistic regression analysis including other risk factors for msOSA demonstrated that high SCPTC scores had an odds ratio for msOSA of 1.77 (95% CI: 1.40-2.23; p<0.001). CONCLUSION: The SCPTC is a reproducible physical exam feature that can be utilized by healthcare providers to screen for patients with msOSA.