To the Editor,
We read with great interest the paper written by Zychlinsky Scharff et al. [1], which helped develop an understanding of the reasoning behind vaccine hesitancy. However, we have noticed several biases within the paper.
Firstly, 10% of the study population had already received at least one dose of the COVID-19 vaccine. It is plausible to suspect their opinions surrounding vaccination may have been influenced by this experience, either positively or negatively. Therefore, we believe the inclusion of these students in this group severely biases the results.
Although parental education level was assessed, there is no indication of the education levels of the students themselves. As German secondary schools are categorised based on academic strength, it is important to highlight which types of schools were included. If relationships are to be drawn between educational background and vaccine hesitancy of the parents, it comes naturally that the child’s decision-making could also be influenced by their own educational background.
Finally, Paulsen et al. sourced their population from the study population of a larger longitudinal study [2]. However, there were large discrepancies between the papers. Collected from a single time window starting in May 2021, Zychlinsky Scharff et al. report to have included 903 participants in this study from two schools. When examined closely, Paulsen et al. reported 469 students surveyed in May 2021, from one school. With such large differences in population size, such discrepancies must be explained before any statistical analyses conducted in this paper could be interpreted with sufficient confidence.
With Europe recovering from another recent surge in COVID-19 cases, the issue of vaccine hesitancy has returned to the spotlight. While highlighting important factors, we would like to seek more information regarding the population selected in this study to assess whether the findings are interpretable for the greater population.
Author contribution
Both authors contributed equally to this article.
Declarations
Conflict of interest
The authors declare no competing interests.
Footnotes
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References
- 1.Zychlinsky Scharff A, Paulsen M, Schaefer P, Tanisik F, Sugianto RI, Stanislawski N, Blume H, Schmidt BM, Heiden S, Stiesch M, Melk A (2021) Students’ age and parental level of education influence COVID-19 vaccination hesitancy. Eur J Pediatr 10–15. 10.1007/s00431-021-04343-1 [DOI] [PMC free article] [PubMed]
- 2.Paulsen M, Zychlinsky Scharff A, de Cassan K, Sugianto RI, Blume C, Blume H, Christmann M, Hauß C, Illig T, Jonczyk R, Klopp N, Kopfnagel V, Lichtinghagen R, Lucas H, Luhr A, Mutschler F, Pietschmann T, Pott P-C, Prokein J, Melk A (2021) Children and adolescents’ behavioral patterns in response to escalating COVID-19 restriction reveal sex and age differences. J Adolesc Health 1–9. 10.1016/j.jadohealth.2021.11.021 [DOI] [PMC free article] [PubMed]