Parents' perception and their decision on their children's vaccination against seasonal influenza in Guangzhou, China

Abstract

Objectives: To identify factors that are important for parental decisions on vaccinating their children against seasonal influenza based on a modified health belief model.

Study design: Cross-sectional study

Subjects: A total of 325 parents who had at least one child aged between 6 months and 3 years were recruited from a women and children’s hospital in Guangzhou, China

Methods: Eligible subjects were identified by doctors when parents took their children to the outpatient clinic for regular body examination. Each eligible subject was invited for a face-to-face interview based on a standardized questionnaire. Hierarchical logistic regression models were conducted to identify factors associated with parents' intention to vaccinate their children and children’s actual vaccination uptake against seasonal influenza on the basis of a modified health belief model.

Results: Uptake of seasonal influenza within the preceding 12 months among the target children who aged between 6 and 36 months was 47.7%. Around 62.4% parents indicated as being “likely/very likely” to take their children for seasonal influenza vaccination in the next 12 months. The hierarchical logistic regression model showed that children’s age (OR=2.59, 95%CI: 1.43-4.68), social norm (OR=2.08, 95%CI: 1.06-4.06) and perceived control (OR=2.96, 95%CI: 1.60-5.50) were significantly and positively associated with children’s vaccination uptake within the preceding 12 months; children with a history of taking seasonal influenza vaccine (OR=2.50, 95%CI: 1.31-4.76), perceived children’s health status (OR=3.36, 95%CI: 1.68-6.74), worry/anxious about their children influenza infection (OR=2.31, 95%CI: 1.19-4.48) and perceived control (OR=3.21, 95%CI: 1.65-6.22) were positively association with parental intention to vaccinate their children in the future 12 months. However, anticipated more regret about taking children for the vaccination was associated with less likely to vaccinate children within the preceding 12 months (OR=0.21, 95%CI: 0.08-0.52).

Conclusions: The modified health belief model provided a good theoretical basic for understanding factors associated with parents’ decisions on their children's vaccination against seasonal influenza. It is important to provide sufficient information related to influenza vaccination benefit and improve parents' confidence to access the seasonal influenza vaccine to promote parents' intention to vaccinate their children against seasonal influenza. Providing information cues such as advice from other parents whose children have been vaccinated to increase adherence to positive social norms would be effective to encourage seasonal influenza vaccination uptake among children. Information communication should also target on reducing anticipated regret about the negative consequence of vaccinating children.