Date of Conferral

5-23-2025

Date of Award

May 2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Lee Caplan

Abstract

Adolescent completion of pertussis-containing vaccines is a public health concern, especially with rising online anti-vaccine misinformation. Incomplete vaccination increases risk for preventable diseases and impacts community health. A gap in the literature on the relationship between online anti-vaccine search trends during the COVID-19 pandemic and adolescent pertussis vaccine completion was addressed in this quantitative, repeated cross-sectional study. Andersen’s behavioral model of health services use guided the study. Secondary data from the 2019 and 2022 National Immunization Survey-Teen (NIS-Teen) compared adolescents aged 13–17 in the five U.S. states with the highest (n=5,464) versus the five with the lowest (n=3.031) population-adjusted anti-vaccine Google search activity from 2020 to 2021(N=8,495). Associations between vaccine completion and race/ethnicity, maternal education, poverty status, and marital status were examined with multivariable logistic regression. Univariate analysis found completion was significantly lower in high-sentiment states than low-sentiment states in 2019 (88.6% vs. 91.7%, p = .011), 2022 (88.9% vs. 91.1%, p = .044), and combined years (88.7% vs. 91.4%, p = .001). Multivariable analysis did not identify statistically significant relationships between demographic variables and vaccine completion (p > .05). Findings suggest demographic factors alone may not explain vaccination differences; online misinformation may influence parental decisions. Implications for positive social change include the potential for public health professionals and policymakers to develop parent-focused internet literacy interventions to counter misinformation and support adolescent vaccine completion.

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