Factors Associated with Receipt of Influenza A (H1N1) 2009 Monovalent and Seasonal Influenza Vaccination Among School-Aged Children — Maricopa County, Arizona, 2009–2010 Influenza Season

Background: Annually in the United States, >200,000 persons are hospitalized and ~24,000 die from influenza-related illnesses; school-aged children can facilitate community-wide influenza spread. During the 2009–2010 influenza season, 572 (76%) of 752 Maricopa County schools initiated school-located influenza vaccination.

Objectives: To determine factors associated with 2009 influenza A (H1N1) monovalent and seasonal vaccination among school-aged children.

Methods: Random-digit telephone dialing was used to identify and survey 600 households with a willing adult participant and Maricopa County school-aged children (grades K–12); information was obtained on two randomly-selected school-aged children and all adults. Two multivariate logistic regression models were used to identify factors associated with either receipt of H1N1 or seasonal vaccine among school-aged children.

Results: To survey 600 (21%) eligible households, 2,843 were contacted. Among 909 school-aged children, 402 (44%) received H1N1 and 436 (48%) received seasonal vaccination. Factors independently associated with H1N1 vaccination (after adjusting for respondent’s education, total household income, race/ethnicity, any adult household member with a high-risk medical condition, and health insurance) included vaccine availability at school (adjusted odds ratio [AOR]: 1.6; 95% confidence interval [95% CI]: 1.1–2.4); high-risk medical condition in child (AOR: 2.3; 95% CI: 1.5–3.7); and elementary compared with high school attendance (AOR: 2.1; 95% CI: 1.4–3.1). Factors independently associated with seasonal influenza vaccination (after adjusting for respondent’s education, household income, and a child with a high-risk medical condition) included Hispanic ethnicity (AOR: 2.0; 95% CI: 1.2–3.4); high-risk medical condition in any adult (AOR: 2.0; 95% CI: 1.2–3.3); health insurance coverage (AOR: 3.6; 95% CI: 1.3–9.7); and elementary compared with high school attendance (AOR: 2.1; 95% Cl: 1.5–3.1).

Conclusions: Our analyses indicate school-located H1N1 vaccinations were independently associated with vaccination of Maricopa County school-aged children. School-located influenza vaccination campaigns potentially could increase school-aged children vaccination rates.