Uptake and acceptability of influenza vaccination in day nursery children

Preschoolers play an important role in the transmission of influenza, and suffer significant morbidity. Paediatric vaccination could prevent serious outcomes and offer broader societal benefits. This study explored parental views on influenza and paediatric vaccination and determined the uptake of a nursery-based vaccination programme for infants aged 6-23 months. Children were offered two doses of inactivated vaccine in 2004/05, and a single dose at the start of the 2005/06 season. An uptake rate of 11% (60/535) was achieved with 83% (50/60) of participants completing the programme. Semi-structured interviews were conducted with 10 parents. Thematic analysis of the data informed the development of a questionnaire. This was distributed to 650 parents, with children aged 6-30 months attending one of the 18 supporting nurseries. A response rate of 13% (83/650) was achieved. The low uptake rate achieved in the programme and findings from the interviews/questionnaire suggest parents were not convinced about the seriousness of paediatric influenza. Indeed, over two-thirds (55/81) questioned the necessity for an annual vaccination. Parents found it difficult to differentiate influenza from other respiratory illnesses, and expressed concerns about the need for annual injections and vaccine safety. Paediatric vaccination to increase herd immunity was held in balance with the notion that children should only be vaccinated if they are the main beneficiaries. Parental education on the burden of childhood influenza, on the direct benefits of influenza vaccination, and on indirect benefits to society is a necessity for a successful paediatric vaccination programme.