title: Predictors of influenza vaccination in the U.S. among children 9-13years of age.
abstract: U.S. estimates of seasonal influenza (flu) vaccine uptake in 2014-2015 were 62% for 5-12year olds, dropping to 47% for 13-17year olds. The Healthy People 2020 goal for these age groups is 80%. It is important to understand factors associated with influenza vaccination, especially for those ages where rates begin to decline. The objective of this study was to identify factors associated with influenza vaccination acceptance in 9-13year old children.
  
  
  
  An online U.S. survey of mothers of children aged 9-13 assessed children's influenza vaccine uptake in the previous season, healthcare utilization, sociodemographics, and vaccine attitudes. Multivariable logistic regression identified independent predictors of influenza vaccine status.
  
  
  
  There were 2363 respondents (Mean age=38years old). Referent children were 57% female and 66% non-minority race/ethnicity with a mean age of 10.6years. By maternal report, 59% of children had received an influenza vaccine in the previous season. Predictors of influenza vaccine uptake included a recommendation or strong recommendation from a health care provider, seeing a health care provider in the past year, positive attitudes regarding the influenza vaccine, and being a minority race. Child gender, age, insurance coverage, and whether the child had a regular healthcare provider were not associated with influenza vaccine uptake (p=n.s.).
  
  
  
  This sample reported overall rates of influenza vaccine uptake similar to national surveillance data, but still lower than national goals. Provider recommendations along with health attitudes and seeing a health care provider were associated with vaccine uptake. Promising interventions may include more directive physician messaging for influenza vaccine uptake in youth, encouraging more regular well-child visits during the adolescent years, and promoting influenza vaccination at alternative sites.
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, United States; Richard M Fairbanks School of Public Health at IUPUI, 1050 Wishard Blvd, Indianapolis, IN 46202, United States. Electronic address: tcumming@iu.edu.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Imburgia
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, United States. Electronic address: kshendri@iu.edu.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Hendrix
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, United States. Electronic address: kldonahu@iu.edu.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Donahue
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, United States. Electronic address: lsturm@iu.edu.
authors.forename: Lynne A
authors.initials: LA
authors.lastname: Sturm
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, United States. Electronic address: gzimet@iu.edu.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Zimet
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009035:Mothers; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines
keywords: Adolescents; Attitudes; Child; Children; Early adolescence; Immunization; Influenza; Vaccination