title: Changes in parents' perceptions of infant influenza vaccination over two years.
abstract: BACKGROUND
  Inner-city health centers serving large proportions of low-income and minority children participated in a study to introduce influenza vaccination among healthy infants in 2002-2003 and 2003-2004.
  
  
  METHODS
  Following the 2002-2003 and 2003-2004 influenza vaccination seasons, a short, low-literacy level survey was mailed to parents of vaccine-eligible children. Factors related to vaccination status were determined using Chi-squared and logistic regression procedures. In 2003, 436 of 1000 surveys were returned and in 2004, 274 of 583 surveys were returned.
  
  
  RESULTS
  Influenza vaccination rate by parental report was 56% in 2003 and 45% in 2004. The most important factors related to immunization were doctor's recommendation (OR = 10.5, 95% CI: 6.2-17.7; P < 0.001), receiving a reminder (OR = 1.6, 95% CI: 1.01-2.6; P = 0.047) and parental belief that the child should be vaccinated (OR = 7.1, 95% CI: 4.3-11.6; P < 0.001). From 2003-2004, nonphysician social influences to have infants vaccinated against influenza increased overall, and perceived positive consequences of vaccination increased among parents of vaccinated children.
  
  
  CONCLUSIONS
  Social support for influenza vaccination of healthy infants increased over the two years of the encouragement period, suggesting that information regarding this vaccine was reaching the general public. The most important facilitators of influenza immunization were physician recommendation, parental support and reminders. This suggests that reminders from physicians should specifically state that the doctor recommends influenza vaccine and address common misperceptions about influenza vaccine. These findings may have broader applications as the age groups for whom influenza vaccination is recommended continue to expand.
authors.affiliation: Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. tnowalk@pitt.edu
authors.forename: Mary Patricia
authors.initials: MP
authors.lastname: Nowalk
authors.forename: Chyongchiou J
authors.initials: CJ
authors.lastname: Lin
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Feng-Shou
authors.initials: FS
authors.lastname: Ko
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hoberman
authors.forename: Lisa
authors.initials: L
authors.lastname: Zoffel
authors.forename: Diana H
authors.initials: DH
authors.lastname: Kearney
mesh_terms: D001741:Black or African American / Q000523:psychology; D016009:Chi-Square Distribution; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000600:supply & distribution*; D007251:Influenza, Human / Q000517:prevention & control*; D016015:Logistic Models; D008913:Minority Groups / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D011203:Poverty; D012944:Social Support; D013997:Time Factors; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines