Change in recommendation affects influenza vaccinations among children 6 to 59 months of age
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Celeste Ojeda Hemingway1, Katherine A Poehling
1Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Insights
Following a 2002-2003 recommendation, pediatric influenza vaccination rates for healthy children aged 6-23 months significantly increased. Physician recommendations strongly influenced vaccination, yet many eligible children remained unvaccinated, highlighting opportunities for improved strategies.
Area of Science:
- Pediatrics
- Public Health
- Immunization Practices
Background:
- The influenza vaccine was recommended for healthy children aged 6-23 months starting in 2002-2003.
- Previous vaccination rates in this age group were low.
- Understanding factors influencing pediatric vaccination is crucial for public health.
Purpose of the Study:
- To assess the impact of the 2002-2003 influenza vaccine recommendation on healthy children aged 6-23 months.
- To identify factors influencing influenza vaccination in young children.
- To evaluate physician recommendation's role in pediatric immunization.
Main Methods:
- A cross-sectional study was conducted in a pediatric clinic setting during summers 2002 and 2003.
- Involved children aged 6-59 months.
- Parental questionnaires determined vaccination status and influencing factors.
Main Results:
- Influenza vaccination rates increased from 7% to 18% overall between 2002 and 2003.
- For healthy children aged 6-23 months, vaccination rose from 1% to 17%.
- Physician recommendation was the strongest predictor (OR: 39.3), but 65% of high-risk children's parents didn't recall a recommendation.
Conclusions:
- The 2002-2003 recommendation led to a significant increase in influenza vaccination for healthy young children.
- Physician recommendations are critical for improving pediatric vaccination rates.
- Opportunities exist to enhance physician communication strategies to boost influenza immunization coverage.
Objective:
To evaluate the impact of the 2002-2003 recommendation to "encourage when feasible" the influenza vaccine for healthy children 6 to 23 months of age.
Methods:
A cross-sectional study of children who were 6 to 59 months of age and presented to a large, pediatric resident's continuity clinic or the affiliated acute care clinic in the summers of 2002 and 2003 was performed. The influenza vaccination status of children in the winter before enrollment and factors that influenced this status were determined by parental questionnaire.
Results:
Of 245 and 329 children in the 2002 and 2003 study populations, influenza vaccinations increased from 7% to 18%, respectively. For healthy children 6 to 23 months of age, influenza vaccinations increased from 1% in 2002 to 17% in 2003 and accounted for most of the increase seen in the study population. Multivariate analysis revealed that the strongest predictor of pediatric influenza vaccination was parental recall of a physician recommendation (odds ratio: 39.3; 95% confidence interval: 17.3-89.4 in 2003). However, 65% of parents of high-risk children did not recall a physician recommendation despite the fact that the influenza vaccine was recommended for high-risk patients during both study years.
Conclusion:
Concomitant with the 2002-2003 influenza vaccine recommendation for healthy children 6 to 23 months of age, influenza vaccinations for these children increased significantly. Because most children for whom the influenza vaccine was recommended were not vaccinated, physicians have the opportunity to increase the pediatric influenza vaccination rate by improving their recommendation strategies.
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