Relationship between the Use of Nonpharmaceutical Interventions and COVID-19 Vaccination Among U.S. Child Care Providers: A Prospective Cohort Study

19 Pages Posted: 6 Dec 2021

See all articles by Kavin Patel

Kavin Patel

Yale University - School of Medicine

Mehr Shafiq

Yale University - Institute for Global Health

Amyn A. Malik

Yale Institute for Global Health

Ayse Cobanoglu

Yale University - Child Study Center

Madeline Klotz

Michigan State University - Human Development and Family Studies

John Eric Humphries

Yale University - Department of Economics

Aiden Lee

Yale University - Department of Economics

Thomas Murray

Yale University - Department of Pediatrics

David Wilkinson

Yale University - Department of Economics

Inci Yildirim

Yale University - Institute for Global Health

Jad A. Elharake

Yale University - School of Medicine

Rachel Diaz

Yale University - Tobin Center for Economic Policy

Rosalia Rojas

Yale University - Child Study Center

Anael Kuperwajs Cohen

Yale University - Child Study Center

Chin R. Reyes

Yale University - Child Study Center

Saad B. Omer

Yale University - Institute for Global Health

Walter Gilliam

Yale University - Yale Child Study Center

Abstract

Background: The relationship between the use of nonpharmaceutical interventions and COVID-19 vaccination among U.S. child care providers remains unknown. If unvaccinated child care providers are also less likely to employ nonpharmaceutical interventions, then a vaccine mandate across child care programs may have larger health and safety benefits.

Methods: To assess and quantify the relationship between the use of nonpharmaceutical interventions and COVID-19 vaccination among U.S. child care providers, we conducted a prospective cohort study of child care providers (N = 20,013) from all 50 states, the District of Columbia, and Puerto Rico. Child care providers were asked to complete a self-administered email survey in May-June 2020 assessing the use of nonpharmaceutical interventions (predictors) and a follow-up survey in May-June 2021 assessing COVID-19 vaccination (outcome). Nonpharmaceutical interventions were dichotomized as personal mitigation measures (e.g., masking, social distancing, handwashing) and classroom mitigation measures (e.g., temperature checks of staff/children, symptom screening for staff/children, cohorting).

Results: For each unendorsed personal mitigation measure during 2020, the likelihood of vaccination in 2021 decreased by 7% (Risk Ratio = 0.93 [95% 0.93 – 0.95]). No significant association was found between classroom mitigation measures and child care provider vaccination (Risk Ratio = 1.01 [95% CI 1.00-1.01]).

Conclusions: Child care providers who used less personal mitigation measures were also less likely to get vaccinated for COVID-19 as an alternative form of protection. The combined nonadherence to multiple types of preventative health behaviors, that is, both nonpharmaceutical interventions and vaccination, among some child care providers may support a role for mandatory vaccination to achieve pandemic control.

Note:

Funding Information: All phases of this study were supported by the Andrew & Julie Klingenstein Family Fund, Esther A. & Joseph Klingenstein Fund, Heising-Simons Foundation, W.K. Kellogg Foundation, Foundation for Child Development, Early Educator Investment Collaborative, Scholastic Inc, Yale Institute for Global Health, and Tobin Center for Economic Policy at Yale University. Dr. Patel is supported by the National Institute of Health.

Declaration of Interests: All authors report no conflicts of interest.

Ethics Approval Statement: All participants provided informed consent prior to data collection. The research protocol was approved by the Yale University Institutional Review Board (protocol number: 2000028232).

Keywords: COVID-19, vaccination, Child Care Providers, Nonpharmaceutical Interventions

Suggested Citation

Patel, Kavin and Shafiq, Mehr and Malik, Amyn A. and Cobanoglu, Ayse and Klotz, Madeline and Humphries, John Eric and Lee, Aiden and Murray, Thomas and Wilkinson, David and Yildirim, Inci and Elharake, Jad A. and Diaz, Rachel and Rojas, Rosalia and Cohen, Anael Kuperwajs and Reyes, Chin R. and Omer, Saad B. and Gilliam, Walter, Relationship between the Use of Nonpharmaceutical Interventions and COVID-19 Vaccination Among U.S. Child Care Providers: A Prospective Cohort Study. Available at SSRN: https://ssrn.com/abstract=3978645

Kavin Patel

Yale University - School of Medicine ( email )

333 Cedar Street
New Haven, CT 06520-8034
United States

Mehr Shafiq

Yale University - Institute for Global Health ( email )

New Haven, CT
United States

Amyn A. Malik

Yale Institute for Global Health ( email )

Ayse Cobanoglu

Yale University - Child Study Center ( email )

New Haven, CT 06520
United States

Madeline Klotz

Michigan State University - Human Development and Family Studies ( email )

East Lansing, MI
United States

John Eric Humphries

Yale University - Department of Economics ( email )

28 Hillhouse Ave
New Haven, CT 06520-8268
United States

HOME PAGE: http://www.johnerichumphries.com

Aiden Lee

Yale University - Department of Economics ( email )

28 Hillhouse Ave
New Haven, CT 06520-8268
United States

Thomas Murray

Yale University - Department of Pediatrics ( email )

United States

David Wilkinson

Yale University - Department of Economics ( email )

28 Hillhouse Ave
New Haven, CT 06520-8268
United States

Inci Yildirim

Yale University - Institute for Global Health ( email )

New Haven, CT
United States

Jad A. Elharake

Yale University - School of Medicine ( email )

333 Cedar Street
New Haven, CT 06520-8034
United States

Rachel Diaz

Yale University - Tobin Center for Economic Policy ( email )

New Haven, CT
United States

Rosalia Rojas

Yale University - Child Study Center ( email )

New Haven, CT 06520
United States

Anael Kuperwajs Cohen

Yale University - Child Study Center ( email )

New Haven, CT 06520
United States

Chin R. Reyes

Yale University - Child Study Center ( email )

New Haven, CT 06520
United States

Saad B. Omer

Yale University - Institute for Global Health ( email )

Walter Gilliam (Contact Author)

Yale University - Yale Child Study Center ( email )

New Haven, CT
United States

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