Association Between Caregiver Opposition to Topical Fluoride and COVID-19 Vaccines

Abstract

Purpose: Caregivers who oppose topical fluoride may be opposed to other preventive treatments, including COVID-19 vaccines. The study objective was to examine the association between caregiver opposition to topical fluoride and COVID-19 vaccines. Methods: The study took place at the University of Washington in Seattle, WA. English-speaking caregivers of children aged <18 years were eligible to participate. An 85-item REDCap survey was administered from February to September 2021. The predictor variable was topical fluoride opposition (no/yes). The outcome was COVID-19 vaccine opposition (no/yes). The models included the following covariates: child and caregiver age; caregiver race and ethnicity, education level, insurance type, parenting style, political ideology, and religiosity; and household income. Logistic regression models generated odds ratios (OR) and 95% confidence intervals (α=0.05). Results: Six-hundred-fifty-one caregivers participated, and 403 caregivers were included in the final regression model. Mean child age was 8.5 years (SD 4.2), mean caregiver age was 42.1 years (SD 9.1), 53.0% of caregivers were female, 57.3% self-reported as white, and 65.5% were insured by Medicaid. There was a significant positive association between topical fluoride and COVID-19 vaccine opposition (OR=3.13; 95% CI: 1.87, 5.25; p<0.001). Other factors associated with COVID-19 vaccine opposition included conservative political views (OR=2.77; 95% CI: 1.26, 6.08; p<0.011) and lower education (OR=3.47; 95% CI: 1.44, 8.38; p<0.006). Conclusions: Caregivers opposed to topical fluoride in dental settings are significantly more likely to oppose COVID-19 vaccines for their child. Future research should identify ways to address both topical fluoride and vaccine opposition to prevent diseases in children.