BACKGROUND:
The Advisory Committee on Immunization Practices recommends all children aged 6-23 months receive annual influenza immunizations. Data from the California and Los Angeles County (LAC) Kindergarten Retrospective Survey indicates that African American (AA) children under 2 have lower immunization coverage rates than other racial/ethnic groups

OBJECTIVE:
Among AA parents/guardians, to identify: 1) factors influencing childhood influenza immunization practices and 2) parental knowledge/attitudes/beliefs (KAB) regarding childhood influenza immunization.

METHOD:
From October through December 2004, seven focus groups (8-12 participants each) were conducted in LAC to determine parental KAB regarding childhood influenza immunization. Participants were recruited from 14 zip codes, identified using 2000 Census data as having a relatively high proportion of AAs (>35%), children under age 5, and residents living below the federal poverty level. Eligible participants were AA parents/guardians who had a child 6-23 months old and lived with the child in the target area. Following the focus group, participants completed a written demographic questionnaire.

RESULT:
Results indicate influenza immunization practices are influenced by: lack of recommendations by family members and doctors; little/no publicity in AA communities or media; inability to easily access influenza vaccine information; the perception of the influenza vaccine as a recommendation rather than requirement; and belief that the vaccine was unnecessary. Participants also expressed concerns about vaccine safety and effectiveness.

CONCLUSION:
Overall, participants were aware of the flu recommendation, but were reluctant to immunize their children. Campaigns and educational materials targeting AAs should aim to alleviate fears that the flu shot causes influenza, use statistics and emotional appeals to illustrate disease severity, provide data on vaccine effectiveness, and explain vaccine contents in an easy-to-understand manner.

LEARNING OBJECTIVES:
To illustrate how knowledge of parental KAB regarding childhood influenza immunization can benefit the development of culturally appropriate immunization messages and materials for LAC's AA community.