Trivalent inactivated influenza vaccine compliance rate in neonatal intensive care unit parents

The American Academy of Pediatrics (AAP) recommends injected, inactivated influenza vaccine for all close contacts of high-risk infants. This population includes parents of infants younger than 59 months of age, with an emphasis on children 0-6 months who are not direct candidates for immunization. This 0-6 month age group is a major component of the neonatal intensive care unit (NICU) population. No data exist on the compliance rate with influenza vaccine in this specific parent population. The purpose of this study was to assess the compliance rate among this parent population and compare it with vaccine use in the general adult population at the time, which has traditionally ranged from 25% to 32%. The study also sought reasons for poor compliance with flu vaccine. Answering this question is important in determining whether programs directly aimed at NICU parents are required to achieve compliance or if simply informing parents of the need to be immunized results in sufficient vaccination rates. For 14 weeks during the 2004-2005 influenza season, 92 randomly selected parents (from 56 inborn infants) underwent an informational program regarding influenza vaccine and the risks and benefits of vaccination. Parents were surveyed in the spring to assess if they obtained the injection the previous winter. Subjects were parents of NICU patients admitted to the New York University NICU during the 14-week study period. The main outcome measure was the influenza vaccination rate of the parental cohort that underwent the informational program. For those who intended to receive influenza vaccination but did not, reasons for noncompliance were assessed via standardized telephone interview. After the information session, 85 parents (92%) indicated they intended to obtain the vaccine; however 30 parents (32.6%) actually received it by the following spring. The most commonly cited reason for failing to obtain influenza vaccine was convenience. No correlation between parents who obtained the vaccine and infant birth weight, gestational age, or length of stay was observed. Compliance with national recommendations to obtain trivalent inactivated influenza vaccine in this highly specified parent population is roughly equivalent to the national average of all adults in the general population. Caregivers of high-risk neonates must encourage/offer immunization to this targeted population.