title: Parental perspectives on influenza immunization of children aged 6 to 23 months.
abstract: BACKGROUND
  For the first time, in 2002, the Advisory Committee on Immunization Practices encouraged the vaccination of healthy children 6 to 23 months against influenza, whenever feasible. Participating inner-city health centers designed interventions to introduce influenza vaccination among this group of children. The study was designed to assess parents' attitudes toward the vaccine.
  
  
  METHODS
  Following the 2002-2003 influenza vaccination season, parents were surveyed to identify barriers to and facilitators of influenza vaccination. A low-literacy level, 19-question survey was mailed to parents in three waves, 4 weeks apart. A subset of children had medical record data available to confirm vaccination status. Measures of validity were calculated. This paper focused only on the children whose parent-reported vaccination status was concordant with that reported in medical records (n = 193). Associations of responses to vaccination status were calculated in 2004, using chi-square and logistic regression procedures.
  
  
  RESULTS
  Sensitivity was 85.7% and specificity was 66% (kappa = 0.50), assessing the ability of parents to recall receipt or nonreceipt of influenza vaccine. The most important factors related to immunization of healthy infants were perceived doctor's recommendation (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 2.4-12.3; p < 0.001) and belief that getting an influenza shot is a smart idea (OR = 3.5; 95% CI = 1.3-8.9; p < 0.01) for those with medical record-confirmed vaccination status.
  
  
  CONCLUSIONS
  A clear message that the doctor recommends influenza vaccination for a child is an important factor for ensuring vaccination, and may foster the idea that vaccination is "smart."
authors.affiliation: Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, PA 15261, USA. tnowalk@pitt.edu
authors.forename: Mary Patricia
authors.initials: MP
authors.lastname: Nowalk
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Chyongchiou J
authors.initials: CJ
authors.lastname: Lin
authors.forename: Feng Shou
authors.initials: FS
authors.lastname: Ko
authors.forename: Mahlon
authors.initials: M
authors.lastname: Raymund
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hoberman
authors.forename: Diana H
authors.initials: DH
authors.lastname: Kearney
authors.forename: David P
authors.initials: DP
authors.lastname: Greenberg
mesh_terms: D003625:Data Collection; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D010290:Parents / Q000523:psychology*; D010414:Pennsylvania
chemical_list: D007252:Influenza Vaccines