Factors affecting parental practices and attitudes toward influenza vaccination for children in China

Influenza presents a severe health threat to children, and influenza vaccination represents the most cost-effective preventive measure. This study was conducted to investigate parents' knowledge, attitudes, and practices (KAP) regarding childhood influenza vaccination and identify key factors affecting vaccination behavior.

A cross-sectional survey was performed among parents of children aged 6 months to 18 years in Jiangsu Province, China, in January 2026. Data were collected using a structured KAP questionnaire. Univariate analyses and multivariate binary logistic regression were used to examine associated factors and independent predictors.

A total of 718 valid questionnaires were analyzed. KAP scores differed significantly by demographic variables. Major barriers to vaccination included safety/side-effect concerns (23.40%), time shortage (14.48%), lack of recommendation (11.84%) and unawareness(10.72%). Regression showed child age, specific vaccine knowledge, perceived necessity, and side-effect worries were independent influencing factors.(all P < 0.05).

Parents in Jiangsu showed moderate knowledge and positive attitudes but low actual vaccination rates. Targeted interventions such as government subsidies, health education, and safety promotion are needed to reduce the cognition-practice gap and improve childhood influenza vaccination coverage.