Factors Impacting Influenza Vaccination of Urban Low-Income Latino Children Under Nine Years Requiring Two Doses in the 2010–2011 Season

Abstract

Background The Advisory Committee on Immunization Practices (ACIP) recommends that certain children under nine years of age receive two influenza vaccine doses in a season for optimal protection. Recent data indicate that many of these children fail to receive one or both of these needed doses. Contributing factors to under-vaccination of this population remain unclear. Methods Caregivers of children aged 6 months-8 years requiring two influenza vaccine doses in the 2010–2011 season were identified from households enrolled in four urban Head Start programs. Recruitment and survey administration were conducted between March and June 2011. The impact of caregiver, provider, and practice-based factors on influenza vaccine receipt (0, 1, or 2 doses) was assessed using bivariate and multivariable logistic regression analyses. Results Caregivers (n=128) were predominantly mothers, Latina, Spanish-speaking, and non-U.S. born. Few children received one (31%) or both (7%) influenza vaccine doses. Caregivers who discussed influenza vaccination with providers were more likely to know their child needed two doses (55% vs. 36%, p<0.05) and have a fully vaccinated child (11% vs. 0%, p<0.05). Among caregivers whose child received the first dose, those who reported being told when to return for the second dose were also more likely to have a fully vaccinated child (35% vs. 0%, p=0.05). Belief in influenza vaccine effectiveness was positively associated with vaccination (p<0.001), while safety concerns were negatively associated (p<0.05). Discussion This study highlights the importance of provider-family communication about the two-dose regimen as well as influenza vaccine effectiveness and safety.

Barriers of Influenza Vaccination Intention and Behavior – A Systematic Review of Influenza Vaccine Hesitancy, 2005 – 2016

“…Having a negative attitude towards the influenza vaccine was a major barrier to vaccine uptake (HCP 7/117 [ 153 , 161 , 227 – 231 ]; Pregnant 6/35 [ 92 , 232 – 236 ]; Chronic 4/45 [ 197 , 237 – 239 ]; Elderly 1/62 [ 222 ]; Public 17/191 [ 12 , 65 , 124 , 128 , 143 , 155 , 198 – 200 , 202 , 220 , 240 – 245 ]). Moreover, individuals who did not believe in the effectiveness of the vaccine showed lower vaccine uptake in every risk group (HCP 11/117 [ 44 , 46 , 48 , 75 , 86 , 130 , 161 , 190 , 194 , 211 , 246 ]; Pregnant 5/35 [ 76 , 116 , 195 , 235 , 247 ]; Chronic 4/45 [ 58 , 96 , 248 , 249 ]; Children 1/18 [ 250 ]; Elderly 1/62 [ 96 , 99 , 100 , 136 , 251 – 253 ]; Public 23/191 [ ...…”

Text Message Reminders for Second Dose of Influenza Vaccine: A Randomized Controlled Trial

“…We previously demonstrated that families may be unaware that a child is in need of 2 doses or when to return. 22 Families may also not understand that timely vaccination is important. 8,12 According to the transtheoretical model of behavior change, an individual needs to move from lack of awareness to contemplation to adoption of a behavior.…”

“…The latter includes lack of knowledge and understanding about influenza and influenza vaccine and confusion regarding need for multiple doses and timing of doses. [22][23][24][25] Conventional text message reminders can notify a family that a vaccine is due and are helpful for those who solely forget to return. However, they presuppose that a family or patient already has the requisite knowledge, attitudes, and motivation to act on them.…”

Parental-Reported Full Influenza Vaccination Coverage of Children in the U.S.

“…34 Barriers to receipt of the second dose might include inconvenience, difficulty making a doctor appointment, insurance/financial barriers, difficulty getting time off of work, lack of provider–parent discussions on the importance of returning for the child's second dose, parental beliefs and attitudes about vaccine effectiveness and safety, or other unknown factors. 35 …”