The association of parental COVID-19 vaccination decisions with the mental health and lifestyle of children and adolescents.

Vaccination rates among adolescents peaked at age 12 and stabilized after 2022 following removal of the Green Pass requirement.

• Study conducted in South Tyrol, Italy using cross-sectional data from 2022 and 2023
• 2022 sample included 6,842 participants aged 7-19 years
• 2023 sample included 4,525 participants aged 7-19 years
• Vaccination uptake stabilized after the Green Pass requirement was removed

Families with consistent vaccination status reported lower mental health burdens in 2022 and better lifestyles in 2023.

• Unadjusted odds ratios were used to identify associations between vaccination rates and lifestyle parameters
• Validated questionnaires assessed mental health problems and health-related quality of life
• Consistently vaccinated families showed lower burden compared to other groups in 2022
• The benefit in lifestyle parameters for vaccinated families was observed in the 2023 data

Unvaccinated families experienced higher mental health burdens and lower quality of life in 2022, but this difference was not observed in 2023.

• Higher burdens were specifically identified in 2022 for unvaccinated families
• Lower quality of life was reported for unvaccinated families in 2022
• The disparity between unvaccinated and vaccinated families was not replicated in the 2023 data
• Both proxy reports and self-reports were used to assess mental health outcomes

Proxy reports indicated fewer mental health issues in vaccinated families, while self-reports revealed more psychosocial problems in unvaccinated families, particularly in 2022.

• Mental health was assessed using the SDQ (Strengths and Difficulties Questionnaire) among other validated instruments
• Proxy reports (parent-reported) and self-reports (child-reported) showed consistent directional findings
• Psychosocial problems were more pronounced in unvaccinated families in the 2022 wave
• The SDQ was used to measure children's mental health outcomes

By 2023, parents who did not respond to the vaccination question faced the greatest burden, and children's mental health and psychosomatic problems remained significantly higher compared to both unvaccinated and vaccinated children.

• Non-responding parents represented a distinct group associated with the worst outcomes in 2023
• Children's SDQ scores and psychosomatic problems were significantly higher in the non-response group
• This group's burden exceeded that of both vaccinated and unvaccinated families in 2023
• The findings suggest non-response reflects a form of vaccine reluctance with distinct and lasting effects on children

Parental vaccine reluctance, particularly non-participation in vaccination programs, was associated with long-lasting psychosocial challenges for affected children.

• The impact of non-response to vaccination extended beyond 2022 into the 2023 data collection period
• Children of non-responding parents showed persistent mental health and psychosomatic issues
• Authors conclude this underscores 'the critical need for tailored public health measures aimed at bolstering confidence in adults' decision-making processes for vaccination'
• The study design was cross-sectional, limiting causal inference