Elsevier

Vaccine

Volume 30, Issue 14, 23 March 2012, Pages 2448-2452
Vaccine

Barriers to and facilitators of child influenza vaccine – Perspectives from parents, teens, marketing and healthcare professionals

https://doi.org/10.1016/j.vaccine.2012.01.049Get rights and content

Abstract

Background

The CDC recommends annual influenza vaccination for all children age 6 months and older, yet vaccination rates remain modest. Effective strategies to improve influenza vaccination for children are needed.

Methods

Eight focus groups with 91 parents, teens, pediatric healthcare staff and providers, and immunization and marketing experts were conducted, audiotaped, transcribed verbatim, and coded based on grounded theory.

Results

Three themes emerged: barriers, facilitators, and strategies. Barriers included fear, misinformation, and mistrust, with exacerbation of these barriers attributed to media messages. Many considered influenza vaccination unnecessary and inconvenient, but would accept vaccination if recipients or other family members were considered high risk, if recommended by their doctor or another trusted person, or if offered or mandated by the school. Access to better information regarding influenza disease burden and vaccine safety and efficacy were notable facilitators, as were prevention of the inconvenience of missing work or important events, and if the child requests to receive the vaccine. Marketing strategies included incentives, jingles, videos, wearable items, strategically-located information sheets or posters, and promotion by informed counselors. Practice-based strategies included staff buy-in, standing orders protocols, vaccination clinics, and educational videos. Teen-specific strategies included message delivery through schools, texting, internet, and social networking sites.

Conclusion

To improve influenza vaccination rates for children using practice-based interventions, participants suggested campaigns that provide better information regarding the vaccine, the disease and its implications, and convenient access to vaccination. Strategies targeting adolescents should use web-based social marketing technologies and campaigns based in schools.

Highlights

► We conducted focus groups regarding perspectives on child influenza vaccination. ► Barriers were fear, mistrust, half truths, inconvenient or unnecessary vaccination. ► Facilitators were access, health promotion, child request, and not missing work. ► Practice-based strategies were staff buy-in, standing orders, and vaccine clinics. ► Teen-specific strategies included using schools and web-based social networks.

Section snippets

Background

The burden of influenza on children is substantial. For every 100 children, an annual average of 6–15 outpatient visits and 3–9 courses of antibiotics are attributable to influenza [1]. Millions of school absences and lost work days among parents caring for sick children occur each year and in 2010–2011, 116 pediatric deaths associated with influenza were reported in the United States [2]. Influenza vaccination provides protection to the individual child, which also confers some protection of

Methods

Focus groups were conducted with healthcare providers, parents, teens, and marketing professionals who were selected to represent a cross-section of socioeconomic status (SES) groups. The purpose of the focus group discussions was to expand current understanding of the barriers and facilitators of childhood immunizations specific to influenza.

Results

Of the 91 individuals who participated in the focus groups, 39 were immunization and health professionals, 21 were parents, 22 were adolescents, and nine were marketing professionals. Participants within all groups were ethnically mixed and included Caucasian, East Asian (Chinese, Thai), Asian Indian, and African American, and Hispanic individuals. Teen participants or parent participants had children who were in public school, private school, and in home school. The majority were female (n = 68)

Discussion

Based on the findings of focus groups of parents, healthcare providers, teens, marketing professionals and other vaccination stakeholders, there are many potential strategies for improving influenza vaccination rates. These strategies parallel those outlined by the Task Force on Community Preventive Services [10] which suggested: (1) increasing demand for vaccine; (2) enhanced access; and (3) improvement in provider interventions. We found that parents, teens and healthcare staff are seeking

Conclusion

To improve influenza vaccination rates for children, participants recommended that influenza vaccination campaigns address the need for vaccination, concerns about safety, vaccine efficacy and indirect benefits to others. They recommended strategies targeting adolescents, using web-based social marketing technologies, improving clinic-based access and developing campaigns based in schools.

Conflict of Interest: Drs. Zimmerman and Lin have research grants from Sanofi. Drs. Zimmerman, Nowalk and

References (16)

There are more references available in the full text version of this article.

Cited by (71)

  • Multi-domain narrative review of vaccine hesitancy in childhood

    2021, Vaccine
    Citation Excerpt :

    Clinicians may dismiss the concerns of the vaccine hesitant child/parent; view the vaccination simply as a task to complete quickly [27,44]; do not take the time and effort to persuade the vaccine hesitant child/parent to vaccinate [45], or even discharge the family from their services if the latter default their vaccination schedule [25]. Thus, it is pertinent to assess clinicians’ attitude and motivation towards vaccination through appraisal and engage them in discussions; empower them with accurate information; clarify their doubts and motivate them to be proactive in initiating conversation with parents to support their children’s vaccination [26,35,46]. Positive attitudes towards vaccination and the belief that vaccination is a public health priority are positively associated with higher vaccination rates [47].

View all citing articles on Scopus
View full text