Research Article: Low coverage of influenza vaccination among Chinese children aged 12-23 months: Prevalence and associated factors

Date Published: October 10, 2018

Publisher: Public Library of Science

Author(s): Joseph T. F. Lau, Catalina S. M. Ng, Anise M. S. Wu, Yee Ling Ma, Mason M. C. Lau, Ray Borrow.

http://doi.org/10.1371/journal.pone.0205561

Abstract

This study aimed to investigate prevalence and associated factors of influenza vaccination (IV) among children aged 12–23 months. Our cross-sectional survey interviewed 489 parents of children aged 12–23 months anonymously at twelve maternal and child health centers in Hong Kong. Results showed that only 11.5% of the children had ever received IV (64.3% being subsidized). Adjusted for the child’s age, significant factors of the children’s IV included parental knowledge about governmental policy/recommendation (Adjusted odds ratio [AOR] = 2.64, 95%CI = 1.09,6.40), knowledge about annual IV requirement (AOR = 2.30, 95%CI = 1.21,4.38), perceived safety-related barrier (AOR≥0.14, 95%CI = 0.06,0.33), cue to action (AOR = 7.79, 95%CI = 3.45,17.58), and subjective norm (AOR = 4.59, 95%CI = 2.34,9.00). IV prevalence of children aged 12–23 months remained low despite a subsidization scheme. The higher IV prevalence of older children reported by other studies suggested that parents postponed action. Promotion campaigns should shift emphases from cost reduction and mass media approaches to dissemination of knowledge about IV policy and safety, enhancement of health professionals’ advice, and creation of supportive subjective norm.

Partial Text

Influenza causes high risk of complications such as pneumonia and bronchitis, which may lead to hospitalizations or even deaths among young children [1,2]. The World Health Organization recommends annual influenza vaccination (IV) to children aged 6–59 months [3]; the Advisory Committee for Immunization Practices in the U.S. also recommended it to children aged 6–23 (2004) and 24–59 months (2006) [4]. Age is important as prevalence of IV concerning <2 or ≥2 years old children differ. Previous studies in the U.S. reported IV prevalence specifically for <2 years old children (56% in 2003 and 31.9% in 2006) [5,6]. Other studies conducted in the U.S. reported IV prevalence both for children aged 6–23 (41.0%-74.4%) and 24–59 months (range = 36%-53.3%) [7–9]. In Spain, there was no noticeable difference between the two age groups (2.2% versus 5.2%) [10]; the younger group showed lower prevalence than the older group of children in Poland (4.1% in 0–1 year, 26.4% in 1–2 years, and 42.3% in 2–5 years) [11]; reverse trends were observed in the U.S. (56% versus 38%) [12] and France (21% versus 15%) [13]. Based on the data of 489 Chinese parents of children aged 12–23 months, the results showed that only 11.5% of the children had ever received IV. The significant factors of the children’s IV included knowledge about the governmental policy/recommendation, knowledge about annual IV requirement, perceived safety-related barrier, cue to action and subjective norm.   Source: http://doi.org/10.1371/journal.pone.0205561

 

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