JMIR Publications

ABSTRACT

Background:

During the early rollout of the children’s COVID-19 vaccine in the United States, there were racial and ethnic vaccination rate disparities. In the Los Angeles area, Hispanic children were less likely to be COVID-19 vaccinated in comparison to non-Hispanic White children. Factors associated with lower vaccination rates among Hispanic children were misinformation and distrust on vaccine safety. Community-partnered research is a powerful tool for building community trust, countering the longstanding history of marginalization in minoritized communities, and developing community-informed approaches to improve health outcomes among vulnerable populations.

Objective:

We conducted a community-based randomized controlled trial (RCT) of a digital intervention to increase COVID-19 vaccine uptake among Hispanic children. The mobile-phone delivered digital intervention was designed in collaboration with community organizations, and linguistically- and culturally-tailored to meet the informational needs of Hispanic parents and caregivers. The intervention focused on families with unvaccinated children 5 to 11 years old, but was offered to families with any unvaccinated children 17 years or younger.

Methods:

We used a Difference-In-Difference (DID) model with an Intention to Treat (ITT) approach. The primary outcome was self-reported COVID-19 vaccine uptake among household children. Secondary outcomes included COVID-19 vaccine knowledge, vaccine trust, and measures of participant engagement. We conducted a sensitivity analysis using Treatment On the Treated (TOT) approach.

Results:

Two hundred fifty-four participants completed the baseline survey. Participants were on average 34 years old and had an average of 2 minors in the household, with 62.2% of households reporting children ages 5-11 years old. Most participants (81.5%) reported English as their primary language, 73.6% were born in the U.S, and 77.2% completed some college or more. We found a statistically significant difference of 13.3% points (95% CI 17.6%, 38.9%; P<.05) in self-reported vaccine uptake between intervention and control groups among parents/caregivers of Hispanic children 5 to 11 years old. We also found a statistically significant difference of 14.3% points (95% CI .0%-23.7%; P<.01) between intervention and control groups in trust of the governmental approval process for the children’s COVID-19 vaccine. Most participants reported the weekly digital videos and educational information were “very” or “extremely” useful (8% and 89%, respectively). We also found 53% of participants clicked thru on a provided link inviting them to make a COVID-19 vaccination appointment.

Conclusions:

This RCT study demonstrates that a culturally tailored, community-based, mobile phone delivered vaccine educational intervention can effectively increase COVID-19 vaccine uptake and trust in governmental vaccine processes among Hispanic children. These findings highlight the potential of community-informed digital strategies, similar to MVLA 2.0, to enhance vaccine trust and uptake. These strategies offer a promising approach for addressing pediatric vaccination gaps across diverse communities, suggesting broader applicability and scalability in public health efforts. Clinical Trial: MiVacunaLA was registered in the NIH Clinical Trials (NCT05234372) on February 8th, 2022 at https://clinicaltrials.gov/study/NCT05234372. MiVacunaLA 2.0 RCT was approved by UCLA IRB Board (#21-000857). We also registered MiVacunaLA 2.0 RCT in the American Economic Association (AEA) RCT Registry (AEARCTR-0011339).