title: Parental knowledge, attitudes, and practices associated with not receiving hepatitis A vaccine in a demonstration project in Butte County, California.
abstract: OBJECTIVE
  To determine hepatitis A vaccination coverage and factors associated with not receiving hepatitis A vaccine among children.
  
  
  METHODS
  A random cluster sample survey was conducted of parents of children who attended kindergarten in Butte County, California, in 2000. Because of a history of recurrent epidemics, an aggressive hepatitis A vaccination program was ongoing during the time this study was conducted. Receipt of 1 or 2 doses of hepatitis A vaccine was studied.
  
  
  RESULTS
  Of 896 surveys sent, 648 (72%) were completed. The vaccination coverage for at least 1 dose of hepatitis A vaccine was 398 (62%) and for 2 doses was 272 (42%). Factors associated with not receiving the vaccine included lack of provider recommendation (vs having recommendation; odds ratio [OR]: 7.8; 95% confidence interval [CI]: 4.9-12.2), not having heard of the vaccine (OR: 2.4; 95% CI: 1.2-4.9), and parent's not perceiving child is likely to get hepatitis A (vs perceiving child might get disease; OR: 2.1; CI: 1.6-2.9).
  
  
  CONCLUSIONS
  Vaccination coverage among kindergartners did not reach high levels (ie, >90%), despite aggressive vaccination efforts in this community. Lack of provider recommendation and lack of parental awareness of hepatitis A vaccine were the 2 most significant factors associated with failure to receive vaccine. These findings will facilitate the development of vaccination strategies for communities in which hepatitis A vaccination is recommended.
authors.affiliation: Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. bfb7@cdc.gov
authors.forename: Barbara
authors.initials: B
authors.lastname: Bardenheier
authors.forename: Idalia M
authors.initials: IM
authors.lastname: González
authors.forename: Michael L
authors.initials: ML
authors.lastname: Washington
authors.forename: Beth P
authors.initials: BP
authors.lastname: Bell
authors.forename: Francisco
authors.initials: F
authors.lastname: Averhoff
authors.forename: Mehran S
authors.initials: MS
authors.lastname: Massoudi
authors.forename: Insu
authors.initials: I
authors.lastname: Hyams
authors.forename: Edgar P
authors.initials: EP
authors.lastname: Simard
authors.forename: Hussain
authors.initials: H
authors.lastname: Yusuf
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002140:California / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006506:Hepatitis A / Q000453:epidemiology / Q000517:prevention & control; D022362:Hepatitis A Vaccines; D006801:Humans; D008297:Male; D032541:Mass Vaccination / Q000523:psychology* / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology*; D010353:Patient Education as Topic; D010372:Pediatrics; D012307:Risk Factors; D012494:Sampling Studies; D012570:School Admission Criteria; D016312:Treatment Refusal / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D022362:Hepatitis A Vaccines