The Determinants of parents for vaccinating their pre-school children against influenza, Xinyi district in Taipei City
Date Issued
2011
Date
2011
Author(s)
Hsien, Pei-Chuan
Abstract
Influenza has characteristics of fast transmission, easy reassortment and involving many different hosts. Therefore, vaccine has been regarded as most important prevention measure in public health. The Department of Health in Taiwan has provided free influenza vaccine for 4-6-year-old children since 2009, yet the vaccine coverage rate of this age group in Xinyi District, Taipei City was relative low (13.86%). This study aimed to investigate the impact of socio-demographic, health belief, preventative behavior, trust ability to government, and medical service on vaccination of influenza by a survey on parents’ willingness of pre-school children influenza vaccination in Xinyi District, Taipei City in 2010.
This cross-sectional study, based on health belief, was conducted from November 15 to November 30, 2010. Of 1529 questionnaires delivered with the assistance of eight nurseries in Xinyi District, Taipei City, 975 questionnaires responded and 525 questionnaires were effective samples (effective sample rate 53.8%). The internal reliability of the questionnaire reached as Cronbac''s α of 0.72. Comparing the differences in factors associated vaccinated vs unvaccinated nursery children, chi-square test was assessed for univariate analysis. Furthermore, the relationship between parents’ confidence in government and their health belief was examined with analysis of variance (ANOVA). Lastly, factors that might be associated with the nursery children receiving the 2010 influenza vaccine were all assessed simultaneously by multivariate logistic regression for controlling important confounders.
The results showed that only 20% of pre-school children received the 2010 seasonal influenza vaccine. The primary factors of parents’ willingness to allow their children to have influenza vaccination were the timing fitting for influenza epidemic season (22%), the effectiveness and safety of vaccine (21%) and being afraid of getting sick (19%). The major factors of parents’ unwillingness to allow their children receiving influenza vaccination were doubtfulness of vaccine safety (21%), negative news of vaccine (15%), their children’s were illness unsuitable for vaccination (15%). Univeraiate analyses found that significant factors for the 2010 vaccinated children were mothers’ occupation, received the 2009 influenza vaccines, providing vaccination service at nursery schools, positive influenza related health belief and trust in Government (p<0.05) whereas those for the 2010 unvaccinated children were lower trust in domestic vaccine (13% vs. 30%, p=0.0002), imported vaccine (31% vs. 54%, p<.0001) and government (27% vs. 50%, p<.0001). Additionally, those who trust government had higher scores in self-awareness of susceptibility and severity of influenza (21.29±2.58 vs. 20.09±2.55，p=0.0011) and lower action barriers (12.98±2.29 vs. 10.39±2.30，p<.0001). Further stepwise logistic regression analysis, controlling age, occupation and educational levels, the important factors for parents decision for children to be vaccinated were experienced the had 2009 influenza vaccination [Adjusted Odds Ratio(OR)=16.6, 95% Confidence Interval (CI) = 6.97-39.50, p<.0001], capability to encourage others to receive influenza vaccine (OR= 1.8, 95% CI = 1.31-2.70, p=0.0005) and their overall satisfaction (OR=2.7, 95% CI=1.75-4.25, p <.0001).
In conclusion, major reasons for unvaccinated pre-school children were the lack of confidence in the vaccine (especially the lowest trust in domestic vaccine). As Taiwan and other countries implemented vaccination campaign in 2009, lacking of better preparedness in risk communication to the public by Government, the most crucial step, before vaccination is led to the uncertainty about influenza vaccine safety, particularly Taiwanese first domestically manufactured vaccine applied to mass-vaccination in schoolchildren in 2009. The key recommendation for increasing vaccine coverage is to elevate vaccine safety and risk communication by providing transparent information, the results of vaccine clinical trials of different brands and adverse events data to the public, advocating the vaccination’s benefit for their closely-related contacts and others, and notifying prevention measures through local clinics, hospitals and health organizations to increase their trust in Government. Facing many influenza epidemic challenges in the future, more different intervention strategies can be carefully evaluated their effectiveness with a prospective study design and supported sold data for providing better evidence-based public health policies.
Subjects
preschool children
influenza vaccine
vaccination
knowledge/attitudes/ behavior
childhood infectious disease
SDGs
Type
thesis
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