Prevalence and associated factors of seasonal influenza vaccination among 24- to 59-month-old children in Hong Kong

Low coverage of influenza vaccination among Chinese children aged 12-23 months: Prevalence and associated factors

“…We included children aged 12 to 23 months, as all children of such age interval could potentially take up IV during that IV season. Furthermore, another independent study [ 16 ] was conducted among parents of children aged 24–59 months in March-June 2011, using the same questionnaire but another sampling method, allowing us to make indirect comparisons between children aged 12–23 months and 24–59 months.…”

“…Different strategies might hence be required to promote IV for the two age groups. While there are a number of studies conducted among children >2 years old and reported factors such as perceived vaccine effectiveness, perceived influenza severity, and subjective norm [ 14 – 16 ]. There are only two related studies conducted among children < 2 years old, which found that health care workers’ recommendation, parental concerns about side-effects, and parental positive attitudes toward IV were significant factors [ 17 , 18 ].…”

“…As the government launched the subsidy policy on IV in 2008/2009, it is meaningful to conduct a study in 2011 to see if the prevalence of IV has increased over a two-year period since the implementation of the new policy. In addition, another local study, which was conducted from March to June 2011 [ 16 ], reported higher IV prevalence of 58.9% among children aged 24–59 months [ 17 ].…”

“…The Health Belief Model (HBM) prescribes parental perceived susceptibility and perceived severity of influenza, and perceived benefit, perceived barrier, cue to actions and self-efficacy related to IV as determinants of young children’s IV [ 23 ]. It has been used to guide variable selection in a local study among 24–59 months old children [ 16 ] and a Taiwan study investigating IV among children aged 6–36 months old [ 24 ], and other studies targeting older people, health care workers, pregnant women, and chronic diseases patients [ 25 – 29 ]. Given its wide applicability, the present study used it as the theoretical framework.…”

“…In addition, subjective norm, defined as perceived support from significant others for performing a health-related behavior, a construct of the Theory of Planned Behaviors (TPB) [ 30 ], was relevant as family members and friends influence parental decision on children’s IV. In the local study [ 16 ], factors of IV for 24–59 months old children included family members’ IV experience, subjective norm and those related to the HBM. Other potential factors of IV included family members’ IV experience [ 8 ] and exposure to influenza-related media messages [ 8 , 31 ].…”