On 29 October 2021, the U.S. FDA authorized the Pfizer-BioNTech COVID-19 (SARS-CoV-2) vaccine for emergency use in children ages 5–11 years. Racial/ethnic minorities have born the greatest burden of pediatric COVID-19 infection and hospitalization. Research indicates high prevalence of parental vaccine hesitancy among the general population, underscoring the urgency of understanding how race/ethnicity may influence parents’ decision to vaccinate their children. Two weeks prior to FDA approval, 400 Hispanic and non-Hispanic Asian, Black, and White parents of children 5–10 years participated in an online survey assessing determinants of COVID-19 pediatric vaccine hesitancy. Compared to 31% Black, 45% Hispanic, and 25% White parents, 62% of Asian parents planned to vaccinate their child. Bivariate and multivariate ordinal logistic regression demonstrated race/ethnicity, parental vaccine status, education, financial security, perceived childhood COVID-19 susceptibility and severity, vaccine safety and efficacy concerns, community support, and FDA and physician recommendations accounted for 70.3% of variance for vaccine hesitancy. Findings underscore the importance of multipronged population targeted approaches to increase pediatric COVID-19 vaccine uptake including integrating health science literacy with safety and efficacy messaging, communication efforts tailored to parents who express unwillingness to vaccinate, and interventions developed in partnership with and delivered through existing trusted community coalitions.

On 17 June 2022, the U.S. FDA authorized the Pfizer-BioNTech and Moderna COVID-19 (SARS-CoV-2) vaccines for emergency use (EUA) in children ages 6 months–4 years. Seroprevalence has increased during the current Omicron variant wave for children under 5 years, and the burden of hospitalization for this age group is similar or exceeds other pediatric vaccine-preventable diseases. Research following the October 2021 EUA for vaccines for children 5–11 indicates a high prevalence of parental vaccine hesitancy and low uptake, underscoring the urgency of understanding attitudes and beliefs driving parental COVID-19 vaccine rejection and acceptance for younger children. One month prior to FDA approval, in the present study 411 U.S. female guardians of children 1–4 years from diverse racial/ethnic, economic, and geographic backgrounds participated in a mixed method online survey assessing determinants of COVID-19 pediatric vaccine hesitancy. Only 31.3% of parents intended to vaccinate their child, 22.6% were unsure, and 46.2% intended not to vaccinate. Logistic regression indicated significant barriers to vaccination uptake including concerns about immediate and long-term vaccination side effects for young children, the rushed nature of FDA approval and distrust in government and pharmaceutical companies, lack of community and family support for pediatric vaccination, conflicting media messaging, and lower socioeconomic status. Vaccine-resistant and unsure parents were also more likely to believe that children were not susceptible to infection and that the vaccine no longer worked against new variants. Findings underscore the need for improved public health messaging and transparency regarding vaccine development and approval, the importance of community outreach, and increased pediatrician attention to parental concerns to better improve COVID-19 vaccine uptake for young children.

As of December 8, 2021, 9.9 million U.S. adolescents ages 12–17 years old remain unvaccinated against COVID-19 (SARS-CoV-2) despite FDA emergency approval of the Pfizer-BioNTech COVID-19 vaccine for use among this age group in May 2021. A slow-down in adolescent vaccine uptake and increased likelihood of hospitalization among unvaccinated youth highlight the importance of understanding parental hesitancy in vaccinating their adolescent children against COVID-19. Racial/ethnic disparities in pediatric COVID-19 infection and hospitalization further underscore the need to examine parental vaccine acceptance and hesitancy among diverse U.S. parent populations. In October 2021, 242 Hispanic and non-Hispanic Asian, Black, and White parents of adolescents ages 12–17 years participated in a national online survey assessing determinants of COVID-19 pediatric vaccine hesitancy. Compared to Asian, Black, and Hispanic parents, non-Hispanic White parents reported reduced odds of having vaccinated their adolescent. Bivariate analyses and a multivariable binomial logistic regression indicated that identification as non-Hispanic White, parental COVID-19 vaccine status and safety measures, COVID-19 misconceptions, general vaccine mistrust and COVID-19 related collectivist and individualist attitudes accounted for 45.5% of the variance in the vaccine status of their adolescent children. Our findings draw attention to the urgent need to consider the COVID-19 beliefs, attitudes, and behaviors of parents from diverse racial/ethnic groups in developing population tailored public health messaging to increase adolescent COVID-19 vaccine uptake.

Introduction: Compared to other-race peers, Black women are disproportionately impacted by human papillomavirus [HPV] infection, related health outcomes, and cervical cancer mortality as a result of suboptimal HPV vaccine uptake during adolescence. Few studies in the United States have examined psychosocial determinants of HPV vaccine acceptability and hesitancy among Black parents. The current study integrated the health belief model and the theory of planned behavior to evaluate the extent to which psychosocial factors are associated with pediatric HPV vaccination intentions among this population.Methods: Black mothers (N = 402; age range = 25 to 69 years, M = 37.45, SD = 7.88) of daughters ages 9 to 15 years completed an online survey assessing HPV infection and vaccine beliefs and attitudes across four domains: Mother’s HPV Perceptions, Mother’s Vaccine Attitudes, Cues to Action, and Perceived Barriers to HPV Vaccination. Participants indicated their willingness to vaccinate their daughter on a 5-level ordinal scale (“I will definitely not have my daughter get the vaccine” to “I will definitely have my daughter get the vaccine”) which was dichotomously recoded for binomial logistic regressions.Results: Half of the sample (48%) intended to vaccinate their daughter. Number of daughters, mother’s HPV vaccine status, perceived HPV vaccine benefits, HPV vaccine safety concerns, pediatric HPV vaccine peer norms, and doctor recommendations emerged as independent factors of Black mothers’ intentions to vaccinate their daughters against HPV when controlling for all other factors.Discussion: In addition to medical training to increase doctor recommendation of the HPV vaccine for Black girls, population-tailored public health messaging aimed at promoting HPV vaccine acceptance among Black mothers is urgently needed. This messaging should engage community support and emphasize the benefits of vaccination for adolescent Black girls while also addressing parental concerns regarding the safety of pediatric HPV vaccination.

Objectives. To assess state laws and regulations mandating sexual education in US public schools in 2025. Methods. We identified and analyzed state statutes, administrative regulations, and state court decisions that mandated sexual education in public schools in every US state and the District of Columbia. We coded content requirements, attributes (e.g., “age-appropriate”), and parental notice and consent policies. Results. Forty-two US states required sexual education in at least 1 content area in K‒12 public schools. Most required education to cover abstinence (34 states), HIV (34 states), sexually transmitted infections (32 states), and child abuse prevention (31 states). Five states required opt-in parental consent; 34 allowed parents to opt children out. Nineteen states mandated medically accurate content for any topic. Conclusions. Although many states mandated sexual education, few required content beyond sexual abstinence, HIV, sexually transmitted infections, and child abuse prevention. Laws that make content optional or facilitate opt-outs can undermine access to this education. Public Health Implications. This detailed accounting of the law will enable researchers and policymakers to identify opportunities to support the implementation of medically accurate, evidence-based sexual education in school settings. ( Am J Public Health. Published online ahead of print August 21, 2025:e1–e11. https://doi.org/10.2105/AJPH.2025.308199 )

On 17 June 2022, the U.S. FDA authorized the Pfizer-BioNTech and Moderna COVID-19 (SARS-CoV-2) vaccines for emergency use in children ages 6 months – 4 years. Seroprevalence has increased during the current Omicron variant wave for children under 5 years and the burden of hospitalization for this age group is similar or exceeds other pediatric vaccine preventable diseases. Research following the October 2021 approval of vaccines for children 5 – 11 indicates high prevalence of parental vaccine hesitancy and low uptake, underscoring the urgency of understanding attitudes and beliefs driving parental COVID-19 vaccine rejection and acceptance for younger children. One month prior to FDA approval, in the present study 411 U.S. female guardians of children 1 – 4 years from diverse racial/ethnic, economic, and geographic backgrounds participated in a mixed method online survey assessing determinants of COVID-19 pediatric vaccine hesitancy. Only 31.3% of parents intended to vaccinate their child, 22.6% were unsure, and 46.2% intended not to vaccinate. Logistic regression indicated significant barriers to vaccination uptake including: Concerns about immediate and long-term vaccination side effects for young children, the rushed nature of FDA approval and distrust in government and pharmaceutical companies, lack of community and family support for pediatric vaccination, conflicting media messaging, and lower socioeconomic status. Vaccine-resistant and unsure parents were also more likely to believe children were not susceptible to infection and that the vaccine no longer worked against new variants. Findings underscore the need for improved public health messaging and transparency regarding vaccine development and approval, the importance of community outreach, and increased pediatrician attention to parental concerns to better improve COVID vaccine uptake for young children.