he aim of this study was to assess factors influencing 2009 H1N1 influenza vaccination among a demographically diverse group of day care-aged children. Day care children were chosenbecause they were an initial target

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Vaccine 30 (2012) 4002– 4006

Contents lists available at SciVerse ScienceDirect

Vaccine

j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / v a c c i n e

orrelates of 2009 H1N1 influenza vaccination among day care-aged children, iami-Dade County

essica Gomez ∗, Fermin Leguen 1, Guoyan Zhang 1, Erin O’Connell 1

iami-Dade County Health Department, 8600 NW 17th Street, Suite 200, Miami, FL 33126 United States

r t i c l e i n f o

rticle history: eceived 5 May 2011 eceived in revised form 8 April 2012 ccepted 10 April 2012 vailable online 25 April 2012

eywords: 009 H1N1 influenza

nfluenza vaccine erception ttitude cceptance hildren

a b s t r a c t

Background: The aim of this study was to assess factors influencing 2009 H1N1 influenza vaccination among a demographically diverse group of day care-aged children. Day care children were chosen because they were an initial target group for vaccination and are at higher risk of influenza infection than children cared for at home. Methods: A cross-sectional study was conducted from March to May 2010 among parents of day care aged children in 13 day care facilities in Miami-Dade County. Data was collected by an anonymous self- administered two-page 20 question survey which consisted of demographic variables and information regarding 2009 H1N1 influenza vaccine knowledge, attitude and acceptance. Data was analyzed using SAS to conduct both bivariate and multivariate analyses. Results: There were 773 participants in the study. The response rate ranged from 42% to 72.2% among day care centers. A total of 172 parents (22.3%) and 225 (29.1%) children had received the 2009 H1N1 influenza vaccine. Non-Hispanic White and Black parents were more likely to vaccinate their children than Hispanic and Haitian parents. Primary reasons for non-vaccination included vaccine safety (36.7%) and side effects (27.1%). Among parents who spoke with a health care professional, 274 (61.4%) statedthe health care professional recommended the vaccine. Conclusion: Misperceptions about influenza vaccination among parents created a barrier to 2009 H1N1 influenza vaccination. Parents who got the vaccine, who believed the vaccine was safe and whose children had a chronic condition were more likely to immunize their children. Clear, reliable and consistent vaccine information to the public and health care providers and initiatives targeting minority groups may increase

ng thvaccination coverage amo

. Introduction

In July 2009, the Advisory Committee on Immunization Prac- ices (ACIP) identified five initial target groups that should receive he 2009 H1N1 influenza monovalent vaccine [1]. Persons aged

months to 24 years were among these initial target groups. In ontrast to seasonal influenza, 2009 H1N1 influenza infection dis- roportionately affects persons under 24 years of age [2]. During he 2009–2010 influenza season, children less than five years of ge had the highest incidence of hospitalization for 2009 H1N1 nfluenza [1].

On September 15, 2009, the Food and Drug Administration (FDA) pproved the distribution of four 2009 H1N1 influenza monovalentaccines in the United States. The 2009 H1N1 influenza vaccina- ion campaign in Miami-Dade County was led by the Miami-Dade ounty Health Department (MDCHD) and began on October

∗ Corresponding author. Tel.: +1 305 234 5400×2553; fax: +1 305 470 5533. E-mail address: yessica gomez@doh.state.fl.us (Y. Gomez).

1 Tel.: +1 305 234 5400×2553; fax: +1 305 470 5533.

264-410X/$ – see front matter. Published by Elsevier Ltd. ttp://dx.doi.org/10.1016/j.vaccine.2012.04.037

is population. Published by Elsevier Ltd.

19, 2009 and ended April 2010. The MDCHD serves Miami- Dade County, an area comprised of 35 municipalities in South Florida with a population of 2.4 million, of which 65.1% are His- panic, 15.4% are non-Hispanic White and 19.0% are non-Hispanic Black [3].

Research has shown that vaccination is the most effective method of preventing and reducing 2009 H1N1 influenza mor- bidity, hospitalization, and mortality [1]. However, influenza vaccination coverage among children during the previous influenza season revealed low compliance with ACIP recommendations [4]. Studies have shown parental vaccine knowledge, attitudes, and perceptions are strong predictors of vaccine acceptance [5,6,18,22]. Little is known about the factors influencing parental acceptance of a new influenza vaccine.

The aim of this study was to assess factors influencing 2009 H1N1 influenza vaccination among a demographically diverse group of day care-aged children. Day care children were chosenbecause they were an initial target