Application of the actor-partner interdependence model to understand COVID-19 vaccine decision-making among US adolescents and their parents.

Although adolescents play an important role in their medical decisions, including vaccination, few studies have considered their perceptions or role in vaccine decision-making. We apply the Actor-Partner Interdependence Model to understand actor (adolescent) and partner (parent) influences of vaccine hesitancy on the decision to vaccinate adolescents. We conducted a nationally representative survey of adolescents aged 12-17 years old and their parents (n = 721 dyads). Parents and adolescents completed separate online surveys measuring their vaccine hesitancy and intent to receive future doses of COVID-19 vaccine. We used structural equation modeling to estimate the association between vaccine hesitancy and adolescent vaccination among actors and partners using odds ratios (ORs) with 95% CIs. We identified a couple-oriented pattern in COVID-19 vaccine decision-making, with significant "actor effects" and "partner effects" on adolescent vaccination. Each unit increase in adolescent vaccine hesitancy was associated with 14% lower odds of adolescent vaccination (OR 0.86 [95% CI, 0.82-0.91]). For each unit increase in vaccine hesitancy among parents, the odds of adolescent vaccination decreased by 6% (OR 0.94 [95% CI, 0.91-0.98]). These findings suggest that vaccine promotion efforts should address vaccine hesitancy in adolescents in addition to their parents.