title: Parental perceptions and predictors of consent for school-located influenza vaccination in urban elementary school children in the United States.
abstract: BACKGROUND
  School-located influenza vaccination (SLV) programs have the potential to mass-vaccinate all enrolled children, but parental consent is required.
  
  
  OBJECTIVE
  To examine parental attitudes and determine predictors of parental consent for vaccination of schoolchildren through SLV programs.
  
  
  METHODS
  Surveys were distributed to parents of 4517 children during 2009-2010 (year 1) and 4414 children during 2010-2011 (year 2) in eight elementary schools in conjunction with a SLV program.
  
  
  RESULTS
  Participants included 1259 (27·9%) parents in year 1 and 1496 (33·9%) in year 2. Parental consent for 2009 H1N1, 2009 seasonal, and 2010 seasonal influenza vaccines was obtained from 738 (70·8%), 673 (64·5%), and 1151 (77·2%) respondents, respectively. During the 2009 pandemic, respondents concerned about influenza severity were twice as likely to consent for the 2009 H1N1 vaccination compared to unconcerned respondents (OR 2·04, 95% CI:1·19-3·51). During year 2, factors that predicted parental consent were the perception of high susceptibility to influenza infection (OR 2·19, 95% CI:1·50-3·19) and high benefit of vaccine (OR 2·23, 95% CI:1·47-3·40). In both years, college-educated parents were more likely to perceive vaccine risks (year 1: 83·6 versus 61·5%, P < 0·001 and year 2: 81·1% versus 60·6%, P < 0·001) and less likely to consent for seasonal influenza vaccine (year 1: OR 0·69, 95% CI:0·53-0·89 and year 2: OR 0·61, 95% CI:0·47-0·78) compared to non-college-educated parents.
  
  
  CONCLUSIONS
  Parents who appreciate the risks of influenza and benefits of vaccination are more likely to consent for SLV. More research is needed to determine how to address heightened safety concerns among college-educated parents.
authors.affiliation: Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Cheung
authors.affiliation: Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA.
authors.forename: Hai-Lin
authors.initials: HL
authors.lastname: Wang
authors.affiliation: Acute Communicable Disease Control, Los Angeles County Department of Public Health, Los Angeles, CA, USA.
authors.forename: Laurene
authors.initials: L
authors.lastname: Mascola
authors.affiliation: Immunization Program, Los Angeles County Department of Public Health, Los Angeles, CA, USA.
authors.forename: Alvin Nelson
authors.initials: AN
authors.lastname: El Amin
authors.affiliation: Division of Infectious Diseases, Children's Hospital Los Angeles, Los Angeles, CA, USA.|Department of Pediatrics and Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Pia S
authors.initials: PS
authors.lastname: Pannaraj
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017589:Immunization Programs; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology / Q000502:physiology; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control* / Q000523:psychology / Q000821:virology; D008297:Male; D010290:Parents / Q000523:psychology*; D010465:Perception; D012574:Schools; D014481:United States; D014504:Urban Health; D014611:Vaccination / Q000523:psychology*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines
keywords: Health belief model; influenza; influenza vaccine; school-located influenza vaccination