Abstract
PURPOSE: This study aimed to examine the relationship between coronavirus disease 2019 (COVID-19) vaccination status and psychiatric symptoms, illness perceptions, avoidance behaviors, and familial vaccination patterns in adolescents referred to a child and adolescent psychiatry outpatient clinic. MATERIALS AND METHODS: This cross-sectional observational study included adolescents (n=168) aged 12-18 years. Participants were categorized as vaccinated (n=74, 44%) or unvaccinated (n=94, 56%). Data were collected using validated instruments, including the Coronavirus Anxiety Scale, Clinical Global Impression-Severity, Strengths and Difficulties Questionnaire-Parent version, and several scales evaluating COVID-19 perceptions, control beliefs, avoidance attitudes, and vaccine attitudes. Mann-Whitney U and χ(2) tests were used for group comparisons. Binary logistic regression was performed to identify predictors of vaccination status. RESULTS: Vaccinated adolescents were significantly older, more likely female, and more frequently had vaccinated siblings and mothers (p<0.05). They reported higher behavioral avoidance and more positive attitudes toward vaccination, while displaying lower hyperactivity/inattention symptoms (p<0.05). Logistic regression revealed that female gender (odds ratio [OR], 5.11; 95% confidence interval [CI], 1.67-15.64), older age (OR, 1.82; 95% CI, 1.38-2.40), sibling vaccination (OR, 4.53; 95% CI, 1.55-13.25), and increased peer problems (OR, 1.40; 95% CI, 1.02-1.93) significantly predicted vaccination status (p<0.05). CONCLUSION: In psychiatrically referred adolescents, COVID-19 vaccination is associated with demographic, familial, and psychological variables. Positive vaccine attitudes, behavioral avoidance, and family modeling increase the likelihood of vaccination, whereas hyperactivity/inattention symptoms may reduce it.