Parent's Decision-Making for Immunizing Children against Seasonal Influenza

Background: While the CDC recommends annual influenza vaccination for all children aged 6 months to 18 years, influenza vaccination rates for children remain low.

Objectives: To investigate the factors that influence parental decision-making regarding children’s influenza vaccination.

Methods:  In August and September 2009, a web-based survey was administered to a nationally representative US sample of 500 parents of children aged 2-12 years selected from a standing panel. The survey, based on conceptual models, included a list of reasons for and against (i.e., drivers and barriers) vaccinating children for influenza.  The importance of each driver or barrier was assessed on a 5-point scale (1=a little important, 5=extremely important). Mean importance ratings were derived for all barriers and drivers.     

Results: The most commonly selected drivers were: to prevent child from getting the flu (95%), doctor recommendation (90%) and to reduce symptoms of the flu (83%).  Highest mean [SD] importance ratings were: to prevent child from getting the flu (4.37 [0.83]), child has other health issues (4.25 [0.98]), and to reduce symptoms of the flu (4.20 [0.92]).  The most commonly selected barriers were:  child is at low risk for flu (46%), flu vaccine can cause the flu (44%), and flu vaccine causes side effects (sore arm, runny nose) (37%).  Highest mean importance ratings were: flu vaccine contains thimerosal (4.21 [0.99]), flu vaccine weakens the immune system (3.89 [0.90]), and flu vaccine is not safe (3.83 [1.15]).

Conclusions: Consistent with previous studies, prevention of flu, reduction of flu symptoms and doctor recommendation were overwhelmingly endorsed as drivers for flu vaccination.  Barriers to vaccination were more variable, but primary reasons included risk of adverse events and perceived low risk of flu.  Health care providers should consider these barriers and drivers when addressing low influenza vaccination rates for children. Sponsored by MedImmune