Knowledge and attitudes about the flu vaccine—especially about its safety and side effects—are the biggest influences in parents' decisions about whether to vaccinate, Sharon G. Humiston, M.D., and her colleagues reported.
The finding may come as a surprise to physicians who view the logistics and cost are the biggest factors, said Dr. Humiston of the University of Rochester (N.Y.), and her associates (Arch. Pediatr. Adolesc. Med. 2005;159:108-12).
“Although health care providers surveyed previously emphasized practicality and convenience, our findings suggest that improving those factors for caregivers is not likely to substantially enhance immunization rates,” they wrote. “Provider time and resources might be better directed at educational and safety concerns.”
The researchers surveyed 153 caregivers of children aged 6-23 months, who presented for care at an ambulatory pediatric clinic or pediatric emergency department. The survey was conducted during the summer of 2003.
Clinic respondents were more likely to be Hispanic or another minority, have lower household incomes, and less education than ED respondents.
Of the entire group, 78% said they intended to have their children vaccinated for the flu that season. But fewer (61%) believed that influenza is serious enough to have all children aged 6-23 months vaccinated. Almost half (49%) believed that the vaccine could cause the flu, 56% said vomiting was a main symptom of the flu, and 63% believed that many babies with the flu need to be hospitalized.
Safety of the vaccine was the most common primary concern (46%). If they had fewer safety concerns, 73% of caregivers said they probably would have their children vaccinated. Prevention of otitis media also was a big issue, with 85% saying they probably would get the vaccine if it prevented OM.
Far fewer caregivers expressed concerns about the number of vaccines a child must have (13.7%), the cost (6.5%), or the number of doctor visits required (4.6%).
Most (68%) said they would get the vaccine if it cost $10-$20, and 51% said they probably would get it even if the cost was more than $20. Extra doctor visits weren't a big concern; 70% reported they probably would still get the vaccine even if it meant another trip. In fact, 94% said a doctor's office or clinic was their first choice of vaccination location. Only 3% said they preferred a public health clinic, 2% said they preferred a school, and 1% said they preferred a grocery store.
The only demographic variable associated with intent to vaccinate was education: Those with a high school education or less were more likely to vaccinate than were those with higher education. The low impact of demographics on intent to vaccinate “might also be attributable to the degree to which parents' concerns and motivations help them overcome barriers imposed by their social locations,” the authors wrote.