KEYWORD1:
Varicella, vaccination, parent survey

BACKGROUND:
Varicella vaccine was licensed in the U.S. in 1995 and the Advisory Committee on Immunization Practices (ACIP) recommends vaccination for children 12 to 18 months of age; however, coverage levels for pre-school children, and factors influencing parents' decisions about varicella vaccination, had not been previously assessed in Minnesota.

OBJECTIVE:
To determine varicella vaccination coverage levels for children attending licensed daycare in Minnesota and to determine parents' knowledge, attitudes, and behaviors regarding this vaccine.

METHOD:
Parents of children 16-33 months of age attending licensed daycare centers in Minnesota were surveyed to elucidate factors associated with varicella vaccination and to determine a baseline varicella vaccination rate among toddlers. Two-stage cluster sampling was performed to randomly select nine children at each of 40 randomly selected daycare centers, following a Probability Proportional to Size (PPS) sampling protocol. Varicella vaccination history was verified with providers.

RESULT:
The majority (78.7%) of 263 toddlers participating in the survey were vaccinated against varicella. Forty (15.2%) reported a history of natural disease. Nearly all (95%) of parents were aware of varicella vaccine, and attitudes toward the vaccine were generally positive. Health care provider recommendation was the strongest predictor of varicella vaccination (OR=14.78).

CONCLUSION:
Because provider recommendation and positive parental perceptions contribute to high varicella vaccination rates, provider and parent education may provide a means to increased coverage levels. Mandating universal varicella vaccination would be generally supported based on these results.
LEARNINGOBJECTIVES:
Describe the methodology, results, and conclusions of a varicella vaccine parent survey and the implications for public health policy.