Influenza Vaccination: Parental Attitudes in the Pediatric Emergency Department

To examine Hispanic parental attitudes towards influenza vaccination, identify dimensions of vaccine hesitancy using the 4C framework (Calculation, Complacency, Confidence, Convenience), and assess parental willingness to have their child receive an influenza vaccine in the emergency department (ED).

In our multi-methods study, Hispanic Spanish-speaking (HS), Hispanic English-speaking (HE), and non-Hispanic White English-speaking (WE) parents answered a semi-structured interview and the Parent Attitudes about Childhood Vaccines (PACV) survey. We extracted themes from interviews using directed content analysis. We summarized PACVs using descriptive statistics (higher scores indicated higher vaccine hesitancy).

From 58 sets of interviews and PACVs, we mapped parents' perceived benefits and barriers of child influenza vaccination to the 4Cs. When compared with WE parents (n=12), HS (n=26) and HE (n=20) parents had less knowledge about influenza and the vaccine, believed more vaccine myths, and were less likely to view influenza as a severe disease. HS and HE parents more often than WE parents expressed community health promotion as a vaccination benefit and poor health care access as a vaccination barrier. PACV scores showed that WE parents were least vaccine-hesitant (M=15.1, SD=15.1), followed by HE (M=22.8, SD=22.1) and HS (M=24.6, SD=14.8) parents. Most parents in all 3 groups expressed willingness to have their child receive the influenza vaccine in the ED.

Influenza vaccine hesitancy is greater among HS and HE parents compared with WE parents. Tailored education to different populations is warranted to increase influenza vaccination within the ED.