Publication date: Jul 30, 2025

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 (OR) with 95% confidence intervals (CI). 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.

Semantics

Original Article