Factors associated with influenza vaccination among US children in 2008

Relative to adults, children have a higher risk of influenza-related illnesses, and they play a major role in the spread of infections through a household. Because the primary caregiver is responsible for the overall health of the child, it is important to analyze the relationship between caregiver characteristics and childhood immunizations. This study examined the characteristics of the caregiver, household, and child to identify factors associated with childhood influenza immunizations.

Data for children aged 19-35 months (n=25,256) were collected from the 2008 National Immunization Survey (NIS). The studied caregiver characteristics included age, education level, and marital status. Demographic variables included the child's age, sex, race/ethnicity, firstborn status, and insurance status in addition to household size, region, and poverty status. All analyses were weighted to reflect the complex sampling frame of the NIS.

Overall, 56.39% of children aged 19-35 months had received a flu vaccination. Factors associated with an increased likelihood of vaccination included the primary caregiver being older, married, and more educated and living in the Northeast. A child with private insurance was more likely to be immunized than a child with any other type of insurance (public: OR 0.6483, 0.5589, 0.7521; no insurance: OR 0.6759, 0.4694, 0.9732). Hispanic children (OR 1.1554, 1.0312, 1.2945) were more likely to be vaccinated than their counterparts.

Understanding the characteristics related to the rates of childhood influenza immunization can help policy makers develop and tailor programs to improve immunization education and delivery, especially to the groups that are least likely to participate.