• In a study conducted among children with COVID-19 using electronic surveys, data regarding COVID-19 symptoms, vaccination status, masking habits, and vaccination status was collected.

• The Social Vulnerability Index is determined based on 15 social factors including poverty, lack of vehicle access, crowded housing, etc.

• The findings of the study are as follows:

1. Masking adherence decreased over time during the study period. 

2. Older children, those in urban counties, and children with low and medium Social Vulnerability Index showed higher levels of masking adherence compared to their respective counterparts.

3. Children with high SVI exhibited lower levels of masking adherence despite being at higher risk for severe outcomes from COVID-19, emphasizing the need for targeted interventions.

4. This study underscored the need to consider social factors while designing public health strategies.

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