337. Prevalence and Determinants of Influenza Vaccination at Tertiary Pediatric Hospitals
Session: Poster Abstract Session: Influenza Vaccine in Children and Adults
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • Prevalence and Determinants of Influenza Infection - Jim Newcombe.pdf (265.9 kB)
  • Background:

    Children with chronic medical conditions are at high risk of severe influenza. Influenza vaccination rates in this population are sub-optimal (11-42%).1,2 We sought to determine influenza vaccine coverage among children attending outpatient clinics in Australia and to identify factors associated with vaccination status. 


    In 2012 we surveyed doctors and parents of children in outpatient clinics at both tertiary pediatric hospitals in Sydney. High risk medical status was determined by medical record review. Vaccination status was determined by parental recall. Both groups were asked about their beliefs and practices regarding influenza and influenza vaccination. We used multivariate logistic models to identify predictors of vaccination status.


    Of 352 surveyed parents, 128 (36%) had high risk children. Of the children ≥6 months old, 50 (41%) in the high risk group received influenza vaccine compared to 28 (14%) in the low risk group (OR: 4.2, 95% CI: 2.4-7.5, p<0.0001). Parents with a university education had a lower vaccine uptake rate (15%) than parents with a high school education or less (33%) (p<0.0001). The strongest predictor of vaccination was a recommendation by a healthcare worker (78% in vaccinated vs. 9% in unvaccinated, adjusted OR: 29.4, 95% CI: 13.6-63.4, p<0.0001). Parental beliefs about the danger of influenza and influenza vaccine safety and effectiveness remained important predictors.

    Of the 101 doctors surveyed, 85 (84%) agreed that influenza is a significant problem for patients with chronic medical conditions while 48/86 respondents (56%) said influenza vaccine was recommended in children with high risk medical conditions. The importance of influenza vaccine was rated lower than the importance of pneumococcal, meningococcal and hepatitis B vaccines (p=0.0001). Better education about influenza vaccine recommendations was rated as the best way to assist influenza vaccination.


    Influenza vaccine coverage in high risk children in our population is low, especially among children of highly educated parents. While parental beliefs are influential, efforts to improve coverage should concentrate on the key role of healthcare workers in recommending vaccination for high risk children.

    1.         MMWR. 2005;54(12):304-307.

    2.         Am J Infect Control. 2008;36(8):582-587.

    James Newcombe, BMedSci(Hons) MPH(Hons) MBBS1, Rajneesh Kaur, BAMS MPH MHM2, Nicholas Wood, MBBS DCH MPH FRACP3, Holly Seale, BSc MPH PhD2, Pamela Palasanthiran, MBBS MD FRACP1 and Thomas Snelling, BMBS(Hons) PhD FRACP3, (1)Department of Immunology and Infectious Diseases, Sydney Children's Hospitals Network, Randwick, Australia, (2)School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia, (3)National Centre for Immunisation Research and Surveillance, Westmead, Australia


    J. Newcombe, None

    R. Kaur, None

    N. Wood, None

    H. Seale, None

    P. Palasanthiran, None

    T. Snelling, None

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