Associated Factors of Behavioral Intention Regarding Childhood Influenza Vaccination Among Parents of Ever-Vaccinated and Never-Vaccinated 24- to 59-Month-Old Children in Hong Kong

Abstract

The World Health Organization recommends young children receive influenza vaccination (IV) annually. Stratified by children’s previous IV status, this study investigated the associated factors of parental intention to let their children aged 24 to 59 months receive IV in the next 12 months in Hong Kong, China. We conducted a cross-sectional population-based telephone survey among 540 Chinese parents of children aged 24 to 59 months. The prevalence of parental intention regarding their child’s IV was 68.9% and 19.8%, respectively, in the ever-vaccinated and never-vaccinated groups. Adjusted for background factors, perceived susceptibility (adjusted odds ratio [ORa] = 3.20, 95% confidence interval [CI] = 1.07-9.54), perceived benefit (ORa = 4.77, 95% CI = 2.52-9.05), perceived barrier (ORa = 0.38, 95% CI = 0.17-0.84), cue to action (ORa = 3.57, 95% CI = 1.88-6.78), subjective norm (ORa = 11.23, 95% CI = 6.17-20.46), and having family members vaccinated (ORa = 1.79, 95% CI = 1.09-2.96) were associated with parental intention for ever-vaccinated children’s IV, while only perceived benefit (ORa = 8.85, 95% CI = 3.36-23.34) and subjective norm (ORa = 21.66, 95% CI = 9.25-50.71) were significant for never-vaccinated children. Our findings showed that the identified factors and applicability of the health belief model varied according to child’s vaccination status. Health promotion should consider segmentation principles. Besides modifying related cognitions like perceived benefit and barrier (only for the ever-vaccinated group), such programs should improve cue to action involving health professionals and family members and create supportive subjective norms.

Influenza Vaccine Uptake in Italy—The 2022–2023 Seasonal Influenza Vaccination Campaign in Italy: An Update from the OBVIOUS Project

“…The lack of concern about children contracting the flu and perceptions of vaccine safety are significant hurdles, as substantiated by Chan et al [ 25 ]. Various studies have also shown how often parents do not consider pediatric influenza serious enough to vaccinate their young [ 26 , 27 ]; our results fall in line with this already-reported trend. Furthermore, our results indicate that even pregnant women express low apprehension about getting sick with influenza, which might be the reason hindering their uptake.…”

Factors Influencing Childhood Influenza Vaccination: A Systematic Review

“…Research frequently explored caregivers’ perceptions of vaccines, which mainly covered four constructs: susceptibility, severity, barriers, and benefits. Six studies employed single-item questions to investigate the above part of constructs, such as perceived benefits and barriers [ 25 , 27 , 29 , 34 , 36 , 38 ], and 12 studies employed self-made or preexisting scales by summary scores of corresponding answers or self-reported scales [ 30 , 31 , 32 , 33 , 35 , 37 , 39 , 40 , 42 , 49 , 50 ].…”

“…Among the included studies, the proportion of parents who perceived a high susceptibility to influenza varied between 10.4% and 83% [ 34 , 42 ]. Meanwhile, 12–82.9% of caregivers believed that influenza was a serious disease [ 37 , 50 ]. Caregivers perceiving more susceptibility and severity to influenza were more likely to vaccinate their children.…”

“…Caregivers’ perceptions of the barriers to vaccination also influenced their decision-making about childhood influenza vaccination. One reason for not vaccinating was concerns about vaccine safety and side effects, as reported by 19.5–61.1% and 19.9–89.8% of caregivers, respectively [ 25 , 29 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 , 49 , 50 , 51 ]. Caregivers expressing more concern about safety (OR = 0.16–0.59) or side effects (OR = 0.17–0.26) were less likely to vaccinate their children [ 29 , 35 , 36 , 42 ].…”

“…Caregivers’ (OR = 5.81–9.1) [ 35 , 36 , 40 ] or children’s (OR = 3.2–15.54) [ 42 , 51 ] previous influenza vaccination experiences were associated with greater childhood influenza vaccination or vaccination intention (OR = 1.79–4.99) in the current flu season [ 27 , 30 , 32 , 39 , 42 , 50 ]. In addition, caregivers working in enterprises (OR = 1.86–3.15) [ 22 , 29 ], or hospitals (OR = 2.36) [ 29 ], having a male child (OR = 1.45–1.58) [ 23 , 24 , 29 ], and a higher education degree (OR = 3.9) [ 22 ] were more likely to vaccinate their children against influenza.…”