The study objective was to identify facilitators and barriers of parental attitudes and beliefs toward school-located influenza vaccination in the United States. In 2009, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention expanded their recommendations for influenza vaccination to include school-aged children. We conducted a systematic review of studies focused on facilitators and barriers of parental attitudes toward school-located influenza vaccination in the United States from 1990 to 2016. We reviewed 11 articles by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. Facilitators were free/low cost vaccination; having belief in vaccine efficacy, influenza severity, and susceptibility; belief that vaccination is beneficial, important, and a social norm; perception of school setting advantages; trust; and parental presence. Barriers were cost; concerns regarding vaccine safety, efficacy, equipment sterility, and adverse effects; perception of school setting barriers; negative physician advice of contraindications; distrust in vaccines and school-located vaccination programs; and health information privacy concerns. We identified the facilitators and barriers of parental attitudes and beliefs toward school-located influenza vaccination to assist in the evidence-based design and implementation of influenza vaccination programs targeted for children in the United States and to improve influenza vaccination coverage for population-wide health benefits.
seen. Boys had slightly higher prevalence of under nutrition (7.9%) than girls (4.8%) and children aged 4e5 years showed the highest prevalence (7.3%). The overall prevalence of parasitic infections was 34.5% (71/206). Two species of parasites were identified; Ascaris lumbricoides (28.5%, 59/206) and Entomeaba coli (10.6%, 22/206). Children with Ascaris infection showed higher prevalence of MAU (10.2%, 6/59) than children infected with Entomeaba coli infections (9.1%, 2/22). No statistically significant association between intestinal parasitic infections and acute under nutrition was found in this study. Interpretation: Acute energy under nutrition is not common in this study group, though high prevalence of intestinal parasitic infections was seen, indicating a high level of transmission. Health education and awareness programs among the study population could be effective for addressing the problem. Funding: No any funds for this study.
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