Why do we not want to recommend influenza vaccination to young children? A qualitative study of Australian parents and primary care providers

Vaccine

Volumn 36, Issue 6, 2018, Pages 859-865

  Biezen, Ruby ^a   Grando, Danilla ^b   Mazza, Danielle ^a   Brijnath, Bianca ^a,c  

^a MONASH UNIVERSITY   (Australia)

^b RMIT UNIVERSITY   (Australia)

^c NATIONAL AGEING RESEARCH INSTITUTE   (Australia)

Author keywords

Children; Influenza; Influenza vaccine; Primary care; Primary care providers

Indexed keywords

INFLUENZA VACCINE;

ADULT; ARTICLE; AUSTRALIA; AUSTRALIAN; CHILD HEALTH CARE; COHORT ANALYSIS; CONTROLLED STUDY; COST BENEFIT ANALYSIS; CROSS-SECTIONAL STUDY; DISEASE SEVERITY; DRUG CONTRAINDICATION; DRUG COST; DRUG EFFICACY; DRUG SAFETY; FEMALE; GENERAL PRACTITIONER; HEALTH CARE ACCESS; HEALTH CARE SURVEY; HIGH RISK POPULATION; HUMAN; IMMUNE RESPONSE; INFLUENZA; INFLUENZA VACCINATION; MALE; MEDICAL DECISION MAKING; MORBIDITY; MORTALITY; NURSE PRACTITIONER; OUTCOME ASSESSMENT; PARENTAL ATTITUDE; PATIENT ATTITUDE; PHARMACIST; PHYSICIAN ATTITUDE; PRIMARY HEALTH CARE; PRIORITY JOURNAL; QUALITATIVE RESEARCH; THEMATIC ANALYSIS; VULNERABLE POPULATION; AGE; CHILD; CHILD PARENT RELATION; HEALTH CARE PERSONNEL; HEALTH SURVEY; IMMUNIZATION; IMMUNOLOGY; INFORMATION PROCESSING; MIDDLE AGED; PRESCHOOL CHILD; SOCIOECONOMICS; VACCINATION; YOUNG ADULT;

ADULT; AGE FACTORS; AUSTRALIA; CHILD; CHILD, PRESCHOOL; CROSS-SECTIONAL STUDIES; FEMALE; FOCUS GROUPS; HEALTH PERSONNEL; HUMANS; IMMUNIZATION SCHEDULE; INFLUENZA VACCINES; INFLUENZA, HUMAN; MALE; MIDDLE AGED; PARENTS; PRIMARY HEALTH CARE; PUBLIC HEALTH SURVEILLANCE; QUALITATIVE RESEARCH; SOCIOECONOMIC FACTORS; VACCINATION; YOUNG ADULT;

EID: 85039958779     PISSN: 0264410X     EISSN: 18732518     Source Type: Journal    
DOI: 10.1016/j.vaccine.2017.12.066     Document Type: Article

References (42)

1. World Health Organization. Influenza (seasonal) fact sheet. World Health Organisation; 2016. Available from: [accessed 15 March 2017].
2. The Department of Health. Annual report of the National Influenza Surveillance Scheme, 2008. The Department of Health, Australian Government; 2010. Available from: [accessed 15 March 2017].
3. Yung, M., Slater, A., Festa, M., Williams, G., Erickson, S., Pettila, V., et al. Pandemic H1N1 in children requiring intensive care in Australia and New Zealand during winter 2009. Pediatrics 127 (2011), e156–e163.
4. Li-Kim-Moy, J., Yin, J.K., Blyth, C.C., Kesson, A., Booy, R., Cheng, A.C., et al. Influenza hospitalizations in Australian children. Epidemiol Infect 145 (2017), 1451–1460.
5. Cromer, D., van Hoek, A.J., Jit, M., Edmunds, W.J., Fleming, D., Miller, E., The burden of influenza in England by age and clinical risk group: a statistical analysis to inform vaccine policy. J Infect 68:4 (2014), 363–371.
6. Wong, K., Cheng, P., Foppa, I., Jain, S., Fry, A.M., Finelli, L., Estimated paediatric mortality associated with influenza virus infection, United States, 2003–2010. Epidemiol Infect 143 (2015), 640–647.
7. Brady, R.C., Hu, W., Houchin, V.G., Eder, F.S., Jackson, K.C., Hartel, G.F., et al. Randomized trial to compare the safety and immunogenicity of CSL Limited's 2009 trivalent inactivated influenza vaccine to an established vaccine in United States children. Vaccine 32:52 (2014), 7141–7147.
8. Flannery BP, Clippard J, Zimmerman RK, Nowalk MP, Jackson ML, Jackson LA, et al. Early estimates of seasonal influenza vaccine effectiveness – United States, January 2015. Centers for Disease Control and Prevention, USA.gov; 2015. Available from: [accessed 15 March 2017].
9. Su, W.-J., Chan, T.-C., Chuang, P.-H., Liu, Y.-L., Lee, P.-I., Liu, M.-T., et al. Estimating influenza vaccine effectiveness using routine surveillance data among children aged 6–59 months for five consecutive influenza seasons. Int J Infect Diseases 30 (2015), 115–121.
10. Blyth, C.C., Jacoby, P., Effler, P.V., Kelly, H., Smith, D.W., Borland, M.L., et al. Influenza vaccine effectiveness and uptake in children at risk of severe disease. Pediatr Infect Dis J, 35, 2016.
11. Wood, N.J., Blyth, C.C., Willis, G.A., Richmond, P., Gold, M.S., Buttery, J.P., et al. The safety of seasonal influenza vaccines in Australian children in 2013. Med J Austr 201:10 (2014), 596–600.
12. Yin, J.K., Salkeld, G., Lambert, S.B., Dierig, A., Heron, L., Leask, J., et al. Estimates and determinants of economic impacts from influenza-like illnesses caused by respiratory viruses in Australian children attending childcare: a cohort study. Influenza Other Respir Viruses 7:6 (2013), 1103–1112.
13. Therapeutic Goods Adminstration. Seasonal flu vaccine: investigation into febrile reactions in young children following 2010 seasonal trivalent influenza vaccination Australia. Department of Health, Australian Government; 2010. Available from: [accessed 6 February 2017].
14. King, C., Leask, J., The impact of a vaccine scare on parental views, trust and information needs: a qualitative study in Sydney, Australia. BMC Public Health, 17(1), 2017, 106.
15. Government of Canada. Influenza vaccine uptake: results from the 2015/16 national influenza immunization coverage survey in Canada. Government of Canada; 2017. Available from: [accessed 6 April 2017].
16. Centers for Disease Control and Prevention. Flu vaccination coverage, United States, 2015-16 influenza season. Centers for Disease Control and Prevention, USA.gov; 2016. Available from: [accessed 18 May 2017].
17. Steinberger S, Pebody R. National Childhood Influenza Vaccination Programme 2015 to 2016 seasonal influenza vaccine uptake for children of primary school age. Public Health England; 2016. Available from: [accessed 17 June 2017].
18. Keenan, H., Campbell, J., Evans, P.H., Influenza vaccination in patients with asthma: why is the uptake so low?. Br J Gen Pract 57 (2007), 359–363.
19. Daley, M.F., Beaty, B.L., Barrow, J., Pearson, K., Crane, L.A., Berman, S., et al. Missed opportunities for influenza vaccination in children with chronic medical conditions. Arch Pediatr Adolesc Med 159:10 (2005), 986–991.
20. Dombkowski, K.J., Davis, M.M., Cohn, L.M., Clark, S.J., Effect of missed opportunities on influenza vaccination rates among children with asthma. Arch Pediatr Adolesc Med 160:9 (2006), 966–971.
21. Djibo, D.A., Peddecord, K.M., Wang, W., Ralston, K., Sawyer, M.H., Factors associated with missed opportunities for influenza vaccination. J Primary Care Commun Health 6:3 (2015), 147–153.
22. Wozniak-Kosek, A., Mendrycka, M., Saracen, A., Kosek, J., Hallmann-Szelińska, E., Zielnik-Jurkiewicz, B., et al. Vaccination status and perception of influenza vaccination in the polish population. Pokorski, M., (eds.) Respiratory virology and immunogenicity, 2015, Springer International Publishing, Cham, 41–46.
23. Alhammadi, A., Khalifa, M., Abdulrahman, H., Almuslemani, E., Alhothi, A., Janahi, M., Attitudes and perceptions among the pediatric health care providers toward influenza vaccination in Qatar: a cross-sectional study. Vaccine 33:32 (2015), 3821–3828.
24. Nowalk, M.P., Lin, C.J., Zimmerman, R.K., Ko, F.-S., Hoberman, A., Zoffel, L., et al. Changes in parents’ perceptions of infant influenza vaccination over two years. J Natl Med Assoc 99:6 (2007), 636–641.
25. Flood, E.M., Rousculp, M.D., Ryan, K.J., Beusterien, K.M., Divino, V.M., Toback, S.L., et al. Parents’ decision-making regarding vaccinating their children against influenza: a web-based survey. Clin Ther 32:8 (2010), 1448–1467.
26. Mills, E.J., Montori, V.M., Ross, C.P., Shea, B., Wilson, K., Guyatt, G.H., Systematically reviewing qualitative studies complements survey design: an exploratory study of barriers to paediatric immunisations. J Clin Epidemiol 58:11 (2005), 1101–1108.
27. Leask, J., Kinnersley, P., Jackson, C., Cheater, F., Bedford, H., Rowles, G., Communicating with parents about vaccination: a framework for health professionals. BMC Pediatr, 12, 2012, 154.
28. Brown, K.F., Kroll, J.S., Hudson, M.J., Ramsay, M., Green, J., Vincent, C.A., et al. Omission bias and vaccine rejection by parents of healthy children: implications for the influenza A/H1N1 vaccination programme. Vaccine 28 (2010), 4181–4185.
29. Michie, S., Johnston, M., Abraham, C., Lawton, R., Parker, D., Walker, A., Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care 14:1 (2005), 26–33.
30. Michie, S., van Stralen, M.M., West, R., The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci, 6, 2011, 42.
31. Biezen, R., Brijnath, B., Grando, D., Mazza, D., Management of respiratory tract infections in young children—a qualitative study of primary care providers’ perspectives. npj Prim CareRespir Med, 27(1), 2017, 15.
32. Victoria State Government. Maternal child health services. Victoria State Government; 2017. Available from: [accessed 15 June 2017].
33. Braun, V., Clarke, V., Using thematic analysis in psychology. Qual Res Psychol 3:2 (2006), 77–101.
34. Blyth, C.C., Jacoby, P., Effler, P.V., Kelly, H., Smith, D.W., Robins, C., et al. Effectiveness of trivalent flu vaccine in healthy young children. Pediatrics 133 (2014), e1218–e1225.
35. Kelly, H., Lane, C., Cheng, A., Influenza vaccine effectiveness in general practice and in hospital patients in Victoria, 2011–2013. Med J Aust, 204(2), 2016, 76.
36. Wu, A.M.S., Lau, J.T.F., Ma, Y.L., Lau, M.M.C., Prevalence and associated factors of seasonal influenza vaccination among 24- to 59-month-old children in Hong Kong. Vaccine 33:30 (2015), 3556–3561.
37. Blyth, C.C., Richmond, P.C., Jacoby, P., Thornton, P., Regan, A., Robins, C., et al. The impact of pandemic A(H1N1)pdm09 influenza and vaccine-associated adverse events on parental attitudes and influenza vaccine uptake in young children. Vaccine, 32, 2014.
38. Mergler, M.J., Omer, S.B., Pan, W.K.Y., Navar-Boggan, A.M., Orenstein, W., Marcuse, E.K., et al. Association of vaccine-related attitudes and beliefs between parents and health care providers. Vaccine 31:41 (2013), 4591–4595.
39. Sampson, R., Wong, L., MacVicar, R., Parental reasons for non-uptake of influenza vaccination in young at-risk groups: a qualitative study. Br J Gen Pract 61:588 (2011), e386–e391.
40. Shono, A., Kondo, M., Factors associated with seasonal influenza vaccine uptake among children in Japan. BMC Infect Dis 15:1 (2015), 1–6.
41. Veitch C, Hollins J, Worley P, Mitchell. General practice research. Problems and solutions in participant recruitment and retention. Austr Fam Phys 2001;30:399–406.
42. Australian Bureau of Statistics. 6306.0 – employee earnings and hours, Australia, May 2012. Canberra: Australian Bureau of Statistics; 2013. Available from: [accessed 4 October 2017].