School-Located Influenza Vaccination: What Do Parents Think?

Background: Schools may be instrumental in achieving universal influenza vaccination for children. Little is known about parents' attitudes about school-located influenza vaccination for elementary school-aged children.

Objectives: To assess, among parents of elementary school students, 1) attitudes about school-located influenza vaccination and about billing for vaccines at school and 2) factors associated with being strongly supportive of their child receiving influenza vaccine at school.

Methods: Survey administered 4/2010-6/2010 to parents of 1000 randomly selected children at 20 elementary schools in Denver, Colorado, at which school-located influenza vaccination with billing had been conducted. Median percentage of students with free and reduced lunch was 87%.

Results: Response rate was 70% (N=699). Among respondents, 90% agreed (67% strongly) that influenza vaccine should be offered at their child's school yearly. Equal percentages of respondents (47%) thought the "best place" overall for their child to receive influenza vaccine was the child's doctor's office and the child's school. Twenty-five percent did not want to give health insurance information necessary for billing for vaccination at school. Factors associated with strongly supporting receipt of vaccine at school included maternal level of education ≤high school diploma (RR 1.25; 95% CI 1.09-1.48), Hispanic ethnicity (1.16; 1.04-1.32), perceiving influenza disease as severe (1.20; 1.09-1.34), belief that influenza vaccine is efficacious (1.34; 1.20-1.50), school delivery is convenient (1.37; 1.23-1.55), and safe (1.52; 1.35-1.72). Not wanting child to be vaccinated without a parent present (0.80; 0.69-0.92) and perceiving it was important to be vaccinated at doctor's office because provider knows child's medical history (0.86; 0.75-0.97) were negatively associated with the outcome.

Conclusions: In this predominately low income population, most parents were strongly in favor of influenza vaccine being offered at school. Parental concerns about not being present for vaccination and billing issues will need to be addressed to optimize sustainability.