Matthew F. Daley1, Lori A. Crane
2, Vijayalaxmi Chandramouli
3, Brenda L. Beaty
1, Jennifer Barrow
1, Norma J. Allred
4, Stephen Berman
1, and Allison Kempe
1. (1) Dept. of Pediatrics, Univ. of Colo. HSC, Children's Outcomes Research Program, The Children's Hospital, 1056 E. 19th Avenue, Denver, CO, USA, (2) Preventive Medicine & Biometrics, University of Colorado Health Sciences Center, 4200 E 9th Ave, Box B-119, Denver, CO, USA, (3) Children's Outcomes Research Program, The Children's Hospital, Denver, CO, USA, (4) Immunization Services Division, HSREB, National Immunization Program, CDC, 1600 Clifton Rd, ND, Mailstop E-52, Atlanta, GA, USA
BACKGROUND:
In Colorado, the 2003-04 influenza season was unusually early and severe, and received substantial media attention.
OBJECTIVE:
Among parents of healthy young children, to 1) determine how knowledge and attitudes regarding influenza immunization (IZ) changed over time, and 2) assess factors predictive of influenza IZ.
METHOD:
We randomly selected 862 healthy children age 6-21 months seen at any of 5 metro Denver pediatric practices. Subjects' parents were surveyed by telephone before (Aug 18-Oct 7, 2003) and after (Mar 29-Jun 09, 2004) influenza season regarding influenza IZ. Change in attitudes was assessed by comparing pre- with post-season responses.
RESULT:
Response rates were 57% (472/862) for the pre-season and 67% (316/472) for the post-season survey. Of 316 parents who completed both pre- and post-season surveys, 258 (82%) immunized their child against influenza. 95% of parents reported hearing about Colorado's influenza outbreak in the media. After the season, parents viewed their child as more susceptible to influenza (p<0.01) and influenza infections as more severe (p<0.01) when compared with pre-season attitudes. Post-season, parents perceived fewer risks associated with influenza IZ (p<0.01), and were more likely to view IZ as the social norm (p<0.01). In multivariate analyses, positive predictors of IZ included: a doctor recommendation for IZ (OR 3.80, 95% CI 1.81-7.95) and a change in the perception that IZ was the social norm (OR 1.99, CI 1.44-2.75). Negative predictors of IZ included: high perceived barriers to IZ (OR 0.41, CI 0.25-0.67); less parental education (OR 0.30, CI 0.14-0.68); and pre-season intention not to immunize (OR 0.08, CI 0.03-0.23).
CONCLUSION:
Parental attitudes about influenza IZ underwent a significant change during the 2003-04 influenza season. Physician recommendation and perceived social norms appear particularly important in influencing parental IZ decisions.
LEARNING OBJECTIVES:
To learn how parental attitudes about influenza IZ changed during the 2003-04 influenza season.
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