Missed Opportunity: Why Parents Refuse Influenza Vaccination for Their Hospitalized Children

Cameron, Melissa A; Bigos, David; Festa, C; Topol, Howard; Rhee, Kyung E.

doi:10.1542/hpeds.2015-0219

Cited by 18 publications

(20 citation statements)

References 11 publications

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“…We also showed that parental vaccine hesitancy was associated with their declining influenza vaccination during their child' s hospitalization. Our findings, along with those from previous studies, 13,14 support the need for strategies to improve influenza vaccine uptake among children who are hospitalized, many of whom have an underlying CD and are at an increased risk of influenza and influenza-related complications. [25][26][27][28][29][30] It is important to acknowledge at the outset that our results need to be interpreted within the context of a low survey response rate and the sampling bias this potentially introduces.…”

Section: Discussionsupporting

confidence: 82%

“…Over half of surveyed parents (53%) declined influenza vaccination for their child during hospitalization, consistent with earlier studies. 13,14 Only half of parents reported that their child was vaccinated against influenza at any point during the 2014-2015 season, falling below national levels (59%) 5,6 and Healthy People 2020 target levels (70%). 32 Parental misreporting due to recall bias may have occurred, although concordance between parent-reported and EHR-documented vaccine receipt in the hospital setting was high.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 Nonetheless, the authors of 2 recent studies found that approximately half of parents declined the influenza vaccine for their vaccine-eligible child during hospitalization. 13,14 Reasons for this are not fully elucidated, although vaccine hesitancy, an important public health issue nationally, [15][16][17][18] could contribute. Using the validated Parent Attitudes about Childhood Vaccine (PACV) survey [19][20][21] (modified for influenza vaccination), researchers of a recent investigation found that parental vaccine hesitancy was associated with declination of the influenza vaccine in the pediatric emergency department (PED).…”

mentioning

confidence: 99%

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Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

Hofstetter

Simon

Lepere³

et al. 2018

Hospital Pediatrics

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Parents frequently decline the influenza vaccine for their child during hospitalization. In this study, we aimed to assess the role of vaccine hesitancy in these declinations. METHODS: This cross-sectional survey study was conducted among English-speaking parents of influenza vaccineeligible children who were hospitalized between October 2014 and April 2015. Between July 2015 and September 2015, parents were recruited via mail to complete the validated Parent Attitudes about Childhood Vaccines (PACV) survey (modified for influenza vaccination). PACV scores (0-100 scale) were dichotomized into scores of $50 (hesitant) and ,50 (nonhesitant). The primary outcome was parental declination of the influenza vaccine for their child during hospitalization. A secondary outcome was the declination reason documented during hospitalization. The main independent variable was parental vaccine hesitancy status, determined by the PACV score. Multivariable logistic regression was used to examine the association between vaccine hesitancy and influenza vaccine declination, adjusting for sociodemographic, visit, and clinical characteristics. The relationship between vaccine hesitancy and declination reason was also explored. RESULTS: Of 199 parents (18% response rate), 24% were vaccine hesitant and 53% declined the influenza vaccine for their child during hospitalization. Vaccine hesitancy (versus nonhesitancy) was associated with declining influenza vaccination (adjusted odds ratio: 6.4; 95% confidence interval: 2.5-16.5). The declination reason differed by vaccine hesitancy status, with a higher proportion of parents who were hesitant versus nonhesitant reporting "vaccine concern" or "vaccine unnecessary." CONCLUSIONS: Vaccine hesitancy was prevalent in this limited sample of parents of hospitalized children and associated with influenza vaccine declination. Additional investigation in a large, diverse, prospectively recruited cohort is warranted given the potential sampling bias present in this study.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

Hofstetter

Simon

Lepere³

et al. 2018

Hospital Pediatrics

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“…9 Another study in 2 community hospitals in California demonstrated that 50.5% of children received influenza vaccination before admission. 10 Although multiple trials have shown that computerized reminders increase the use of preventive care measures in the outpatient setting, 11,12 several studies have failed to demonstrate an increase in the rates of inpatient influenza vaccination through standing orders and alerts in the medical record alone. 13,14 Some studies suggest that a combination of computerized reminders plus staff education leads to increased immunization rates 15,16 and that hospital-based interventions are cost-effective 17 ; however, there is a paucity of data in pediatric inpatients.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Interventions to Increase Influenza Vaccination Rates among Pediatric Inpatients

Rao

Fischman

Kaplan

et al. 2018

Pediatric Quality &Amp; Safety

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Introduction:Hospitalization provides an ideal opportunity for influenza vaccination, and strategies can enhance existing tools within the electronic medical record (EMR). The objectives of the study were to introduce and evaluate the effectiveness of provider and family-directed interventions to increase influenza vaccination ordering among inpatients.Methods:We conducted a quality improvement initiative for children aged older than 6 months on medical inpatient teams at a large pediatric tertiary care hospital from September 2014 to March 2015, comprising 2 intervention groups (provider reminders and family education) and 1 control group for comparison, using EMR prompts alone. The provider reminder interventions comprised weekly e-mails indicating inpatient immunization status; vaccination reports; and visual reminders. The family education group intervention consisted of handouts regarding the benefits and safety of influenza vaccination. We measured vaccine ordering rates for each group among eligible children and overall vaccination rates. Data were analyzed using Statistical Process Control Charts and Chi-square tests.Results:Among 2,552 patients aged older than 6 months hospitalized during the study period, 1,657 were unimmunized. During the intervention period, the provider group ordered 213/409 (52%) influenza vaccines, the family education group ordered 138/460 (30%) and the control group ordered 71/279 (25%) (P < 0.0001). The provider group had higher influenza immunization status than the control group (61% versus 53%; P = 0.0017). Exposure to the intervention did not impact the length of stay/discharge time.Conclusions:Provider reminders including e-mails, visual reminders, and vaccination reports are effective ways of increasing inpatient influenza vaccination rates and are more effective than family education, or EMR prompts alone.

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“…Reasons for parental refusal in our survey are similar to those cited by parents in other studies. 10 Studies have shown that parental acceptance of influenza vaccine was higher when clinicians discussed vaccination using a presumptive format (presume acceptance) rather than a participatory format (parents asked questions about vaccination rather than presume that they will accept the vaccine). 11,12 Teaching providers a presumptive format to initiate a vaccine discussion will be an important step to improve vaccination during future influenza seasons.…”

Section: Discussionmentioning

confidence: 99%

Knowledge Base and Perceptions of Inpatient Providers and Parents About Influenza Vaccination in Hospitalized Children

Mathew

Srinivasan

2020

Global Pediatric Health

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Missed Opportunity: Why Parents Refuse Influenza Vaccination for Their Hospitalized Children

Cited by 18 publications

References 11 publications

Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

Evaluating Interventions to Increase Influenza Vaccination Rates among Pediatric Inpatients

Knowledge Base and Perceptions of Inpatient Providers and Parents About Influenza Vaccination in Hospitalized Children

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