BACKGROUND:
While children with chronic medical conditions have long been targeted for influenza immunization, the ACIP has recently recommended immunization of healthy 6-23 month olds. Little is known about parent KABs regarding influenza immunization in healthy young children.

OBJECTIVE:
Among parents of healthy young children, to determine the KABs that predict parents' intention to immunize their child against influenza.

METHOD:
The study was conducted in 5 metro Denver pediatric practices. Using random selection, stratified by age and practice, we identified 862 healthy children age 6-21 months seen at any of the 5 practices. Subjects' parents were surveyed by telephone in August-October 2003, with up to 20 survey attempts per family. We used the conceptual framework of the Health Belief Model (eg disease susceptibility, severity, benefits of vaccination, barriers) and sociodemographic factors to predict parental plans to immunize their child. Parental intentions (plan to immunize, undecided, plan not to immunize) were predicted using multiple linear regression.

RESULT:
The response rate was 57% (n=482 completed surveys). 36% of respondents were planning to immunize their child against influenza, 32% were undecided, and 32% were planning not to immunize. In multivariate analysis, significant (p<0.05) positive predictors of parental plans to immunize included: belief that the parent's social network (people important to them, other parents) think they should vaccinate their child; belief that their child is more susceptible to influenza than other children the same age; belief that vaccination will decrease school absences; the parent's personal history of ever having been vaccinated against influenza; and the child's doctor having recommended vaccination. Negative predictors included the belief that their child is likely to have a serious reaction to the vaccine and being privately insured vs. publicly insured or uninsured. The regression model predicted 52% of the variance in parental intentions to immunize.

CONCLUSION:
To boost influenza immunization in healthy young children, future educational campaigns should target parents' perceptions of the social norms regarding influenza immunization, their child's susceptibility to influenza, and the benefits and safety of vaccination.

LEARNING OBJECTIVES:
To understand the parental KABs that predict parents' intention to immunize their child against influenza.