Parental perspectives on influenza immunization of children aged 6 to 23 months

Background: For the first time, in 2002, the Advisory Committee on Immunization Practices encouraged the vaccination of healthy children 6 to 23 months against influenza, whenever feasible. Participating inner-city health centers designed interventions to introduce influenza vaccination among this group of children. The study was designed to assess parents' attitudes toward the vaccine. Methods: Following the 2002-2003 influenza vaccination season, parents were surveyed to identify barriers to and facilitators of influenza vaccination. A low-literacy level, 19-question survey was mailed to parents in three waves, 4 weeks apart. A subset of children had medical record data available to confirm vaccination status. Measures of validity were calculated. This paper focused only on the children whose parent-reported vaccination status was concordant with that reported in medical records (n=193). Associations of responses to vaccination status were calculated in 2004, using chi-square and logistic regression procedures. Results: Sensitivity was 85.7% and specificity was 66% (κ=0.50), assessing the ability of parents to recall receipt or nonreceipt of influenza vaccine. The most important factors related to immunization of healthy infants were perceived doctor's recommendation (odds ratio [OR]=5.5; 95% confidence interval [CI]=2.4-12.3; p<0.001) and belief that getting an influenza shot is a smart idea (OR=3.5; 95% CI=1.3-8.9; p<0.01) for those with medical record-confirmed vaccination status. Conclusions: A clear message that the doctor recommends influenza vaccination for a child is an important factor for ensuring vaccination, and may foster the idea that vaccination is "smart."