Vaccine hesitancy and influenza beliefs among parents of children requiring a second dose of influenza vaccine in a season: An American Academy of Pediatrics (AAP) Pediatric Research in Office Settings (PROS) study

Abstract

To receive adequate protection against influenza, some children 6 months through 8 y old need two doses of influenza vaccine in a given season. Currently, only half of those receiving the first dose receive a second. Our objective was to assess vaccine hesitancy and influenza disease and vaccine knowledge, attitudes, and beliefs among caregivers of children who received the first of their two needed doses. As part of a national-randomized control trial of second dose text-message influenza vaccine reminders (2017-2018 season), a telephone survey collected caregiver and index child demographic information. Each child had received the first of two needed influenza vaccine doses. Caregivers completed a measure of general vaccine hesitancythe five-question Parent Attitudes About Childhood Vaccines Survey Tool (PACV-5)and questions about influenza infection and vaccine. We assessed associations between participant demographic characteristics, vaccine hesitancy, and influenza beliefs and calculated the standardized proportion of caregivers endorsing each outcome using logistic regression. Analyses included responses from 256 participants from 36 primary care practices in 24 states. Some caregivers (11.7%) reported moderate/high vaccine hesitancy and many had misperceptions about influenza disease and vaccine. In multivariable models, no single variable was consistently associated with inaccurate knowledge, attitudes, and beliefs. These results demonstrate that caregivers whose children received the first dose of influenza vaccine may still be vaccine hesitant and have inaccurate influenza beliefs. Pediatricians should consider broadly addressing inaccurate beliefs and promoting vaccination even after caregivers agree to the first dose.

What Is the State-of-the-Art in Clinical Trials on Vaccine Hesitancy 2015–2020?

“…The number of trials about vaccine hesitancy on specific diseases was also restricted (e.g., Human papillomavirus infection; influenza; diphtheria tetanus toxoid and pertussis and COVID-2019) [ 9 , 10 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ].…”

“…Only two controlled trials with hesitant participants on getting influenza vaccination were identified [ 10 , 40 ]. Positively, one study was multicentric (36 primary care practices in 24 states) [ 10 ], although none of the identified studies was representative at national level [ 10 , 40 ]. Pediatricians should promote vaccination after the administration of the first dose of influenza vaccine since many caregivers remain vaccine hesitant even after the administration of the first dose.…”

“…Pediatricians should promote vaccination after the administration of the first dose of influenza vaccine since many caregivers remain vaccine hesitant even after the administration of the first dose. Additionally, health professionals should address inaccurate influenza beliefs for the reason that parents showed misperceptions about influenza disease and vaccination [ 10 ]. Participant’s perceptions and attitudes about vaccination were not modified by online messages (i.e., original participants’ perceptions and attitudes were dominant), with participants not disseminating these messages [ 40 ].…”

“…Vaccine hesitancy should be studied in diverse settings since this condition is multifactorial and context-specific [ 4 ]. For instance, parent’s beliefs and attitudes [ 7 ]; online or electronic information [ 8 ]; type of vaccine-preventable disease (e.g., human papillomavirus infection or influenza) [ 9 , 10 ]; pain or fear of needles [ 11 , 12 ] or training/education on vaccination [ 13 ] may influence vaccine hesitancy [ 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Influenza vaccination among U.S. pediatric patients receiving care from federally funded health centers

“…Similarly, the study did not examine the role of knowledge, attitudes, and practices toward vaccines among parents of pediatric health center patients, which might influence the decision to obtain influenza vaccinations. Recent literature illustrates that parental concerns about seasonal influenza vaccine exist, including beliefs that the vaccine causes influenza illness, the vaccine is unnecessary because influenza illness is mild, and the vaccine is not effective [46][47][48][49]. Beyond concerns specific to influenza vaccine, more generalized concerns may influence decisions to vaccinate.…”