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Childhood Influenza Vaccination and Its Determinants during 2020-2021 Flu Seasons in China: A Cross-Sectional Survey
Kaiyi Han1,2, Zhiyuan Hou1,3, Shiyi Tu1,3
1School of Public and Health, Fudan University, Shanghai 200032, China.
Insights
Seasonal influenza vaccination coverage in young Chinese children is low at 43.63%. Factors influencing uptake include caregiver education, income, confidence in vaccine safety and effectiveness, and healthcare worker recommendations. Improving access and targeted campaigns are crucial.
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- Young children (6–59 months) are a priority group for seasonal influenza vaccination in China.
- Understanding vaccination coverage and influencing factors is essential for public health strategies.
Purpose of the Study:
- To assess seasonal influenza vaccination coverage among children under five years old in three Chinese provinces.
- To identify factors associated with influenza vaccination uptake in this population.
Main Methods:
- Cross-sectional survey conducted in September 2021 involving 2081 caregivers of children under five.
- Self-administered questionnaires were used to collect data.
- Logistic regression analysis was employed to determine factors associated with vaccination.
Main Results:
- Overall influenza vaccination coverage was 43.63% for the 2020–2021 flu season.
- Caregivers with higher education, higher income (though <20,000 RMB), and residing in Anhui province were more likely to vaccinate.
- Confidence in vaccine importance, safety, and effectiveness, positive influence from healthcare workers and social networks, and perceived peer vaccination behavior were significant positive predictors. Poor access to services was a negative predictor.
Conclusions:
- Targeted public health campaigns are needed to enhance caregiver confidence, particularly among less educated and lower-income groups.
- Interventions to improve vaccination service accessibility, such as extended hours and proximity, are recommended.
- Engaging healthcare providers and monitoring public perception are vital for increasing childhood influenza vaccination rates.
Abstract:
Young children aged 6−59 months are recommended as one of the priority groups for seasonal influenza vaccination in China. This study assessed influenza vaccination coverage and the factors associated with vaccination uptake among children in three Chinese provinces. In September 2021, 2081 caregivers with children <5 years completed self-administered questionnaires as part of a cross-sectional survey. Logistic regression was used to assess determinants of childhood influenza vaccination. A total of 43.63% of respondents reported vaccinating their children against influenza during the 2020−2021 flu season. Caregivers who lived in Anhui province, had a bachelor degree or above, and an annual household income <20,000 RMB were more likely to vaccinate their children against influenza. Confidence in the importance (OR: 2.50; 95%CI: 1.77−3.54), safety (OR: 1.60; 95%CI: 1.29−1.99), and effectiveness (OR: 1.54; 95%CI: 1.23−1.93) of influenza vaccine was significantly associated with childhood vaccine acceptance. Respondents who saw that other caregivers were vaccinating their children had significantly higher odds of vaccinating their own children. Caregivers’ receiving positive influence from healthcare workers (OR: 1.33; 95%CI: 1.00−1.77), family members, or friends (OR: 1.30; 95%CI: 1.14−1.49) were also significantly associated with childhood influenza vaccination. Poor access, including conflicts between caregivers’ availability and vaccination service schedules and inconvenient transportation to the vaccination site were negatively associated with childhood flu vaccination. To promote childhood influenza vaccination, public health information campaigns need to target wealthier and less educated caregivers to enhance caregivers’ confidence in influenza vaccination. Targeted interventions are also needed to optimize access to vaccination services, including extending vaccination service hours and increasing the number of vaccination sites close to residential areas. Interventions are also needed to encourage primary care providers to play a greater role in promoting vaccination. Finally, the dissemination of related information and the public response need to be monitored for the timely understanding of public perceptions.
