title: Parental perspectives on influenza vaccination of children with chronic medical conditions.
abstract: BACKGROUND
  Minorities and those living in the inner city have a higher respiratory disease burden than other groups. Yet, influenza vaccination rates among all children with chronic medical conditions remain low.
  
  
  METHODS
  Parents of 2-13-year-old children with high-risk medical conditions from health centers in low-income urban neighborhoods completed a mailed survey. Immunization status from medical records was used to calculate validity measures. Survey data are presented for those whose vaccination status was concordant between parental report and the medical record (n=183).
  
  
  RESULTS
  Parent-reported influenza vaccination versus medical record review showed 84.9% sensitivity, 68.7% specificity, 49.1% positive predictive value and 92.7% negative predictive value, with a kappa of 0.43. Vaccination rate was 30.6%. Medical record-verified influenza vaccination was associated with parental beliefs that the doctor recommends a flu shot (OR, 40.9; 95% Cl, 9.0-184.9) and that relatives recommend a flu shot (OR, 4.3; 95% Cl, 1.7-10.5), and was less likely if the parent believed that the child will get the flu if a household member is infected (OR, 0.2; 95% Cl, 0.1-0.6).
  
  
  CONCLUSIONS
  The message that influenza vaccination is important to protect children with chronic medical conditions may be relayed through physician recommendation or a relative's suggestion and may be more effective if it addresses vaccine efficacy issues.
authors.affiliation: Department of Pediatrics, University of Pittsburgh School of Medicine Pittsburgh, PA 15261, USA.
authors.forename: Chyongchiou J
authors.initials: CJ
authors.lastname: Lin
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Mary Patricia
authors.initials: MP
authors.lastname: Nowalk
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: Bruce
authors.initials: B
authors.lastname: Block
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D010290:Parents / Q000523:psychology*; D010414:Pennsylvania; D017010:Reminder Systems; D012621:Seasons; D012923:Social Class; D012938:Social Perception; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014505:Urban Population
chemical_list: D007252:Influenza Vaccines