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Missed Opportunity: Why Parents Refuse Influenza Vaccination for Their Hospitalized Children
Melissa A Cameron1, David Bigos2, Christopher Festa2
1Department of Pediatrics, Division of Hospitalist Medicine, Rady Children's Hospital-San Diego, San Diego, California; mcameron@rchsd.org.
Insights
Nearly half of parents refused the influenza vaccine for their hospitalized children. Key reasons included preference for primary care provider vaccination and concerns about side effects or efficacy.
Area of Science:
- Pediatrics
- Public Health
- Vaccinology
Background:
- Hospitals aim to vaccinate all admitted children against influenza.
- Current influenza vaccination rates in pediatric hospital inpatients remain low.
- Understanding refusal reasons is crucial for improving vaccination uptake.
Purpose of the Study:
- To investigate parental reasons for declining influenza vaccination in pediatric hospital admissions.
- To identify factors associated with vaccine refusal in an inpatient setting.
Main Methods:
- A prospective study of children aged 6 months to 18 years admitted to two hospitals during influenza season (Oct 2013 - Mar 2014).
- Parents of eligible children who refused influenza vaccination were surveyed for their reasons.
- Chi-square tests and logistic regression analyzed factors associated with refusal.
Main Results:
- 49.8% of 325 eligible pediatric patients refused influenza vaccination.
- Refusal was higher among parents of females, white children, and those with private insurance.
- Common reasons: preference for primary care provider (24.1%), side effect concerns (16.1%), and vaccine doubt (8%).
Conclusions:
- Hospitalization presents a key opportunity for influenza education and vaccination.
- Nearly half of parents declined influenza vaccination for their hospitalized children.
- Further research is needed to develop effective strategies for increasing inpatient pediatric influenza vaccination acceptance.
Background And Objectives:
Hospitals are required to screen and administer the influenza vaccine to all admitted children unless contraindicated or refused by parents, yet vaccination rates remain low. Our goal was to examine reasons for refusal among pediatric patients admitted during influenza season.
Methods:
All children age 6 months to 18 years admitted to 2 network community hospitals from October 1, 2013 to March 31, 2014, without contraindications, were offered influenza vaccination prior to discharge. Parents who refused vaccination were asked their reason for refusal. Chi-square tests and logistic regression were used to determine factors associated with refusing the vaccine in the inpatient setting.
Results:
Three hundred twenty-five of 786 unique patients admitted during influenza season were eligible for vaccination. Of these, 49.8% refused. Parents of females, whites, and those with private insurance were more likely to refuse vaccination. Patients whose immunization status was otherwise up to date were more likely to accept (Odds Ratio 2.39, 95% Confidence Interval 1.05-5.41). Commonly cited reasons for refusal were: preference to have vaccination by the primary care provider (24.1%), concern for side effects (16.1%), not wanting vaccination (13%), doubt in efficacy (8%), concern that the child was already sick (6.8%), no prior influenza vaccination (6.7%) and feeling that it was not needed (5.6%).
Conclusions:
Hospitalization during influenza season provides an opportunity for health-care providers to educate families about influenza and vaccinate patients if appropriate. However, nearly half of parents of eligible children declined vaccination. More study is required to determine strategies that can increase influenza vaccination acceptance.
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