Parental vaccine hesitancy and acceptance of seasonal influenza vaccine in the pediatric emergency department

Strelitz, Bonnie; Gritton, Jesse; Klein, Eileen J.; Bradford, Miranda C.; Follmer, Kristin; Zerr, Danielle M.; Englund, Janet A.; Opel, Douglas J.

doi:10.1016/j.vaccine.2015.02.034

Cited by 72 publications

(81 citation statements)

References 27 publications

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“…Our finding that nearly one-fourth of surveyed parents of hospitalized children were vaccine hesitant is consistent with PACV studies conducted among parents of children who were cared for in the hospital's PED 22 as well as parents of 19-to 35-month-old infants who were cared for in a regional health maintenance organization. 20 Lower hesitancy levels (9%-15%) were observed in PACV studies conducted prospectively among parents of 2-month-old infants in this region and parents of 2-week-old infants in a private pediatric clinic in Tennessee.…”

Section: Discussionsupporting

confidence: 88%

“…The main independent variable was vaccine hesitancy status. As described previously, 21,22 each of the 15 PACV item responses were collapsed into 3 categories (nonhesitant, not sure, and hesitant) and assigned a score of 0 (nonhesitant), 1 (not sure), or 2 (hesitant). The total raw score was converted to a 0-to 100-point scale by using simple linear transformation that accounted for missing data and then dichotomized into scores of ,50 (nonhesitant) and $50 (hesitant).…”

Section: Methodsmentioning

confidence: 99%

“…20,21 The PACV survey has been modified and validated for use with the influenza vaccine specifically. 22 Response formats vary and include dichotomous replies, 5-point Likert scales, and 11-point scales. We also included 8 sociodemographic items and 2 items regarding the child' s receipt of the influenza vaccine during hospitalization (in case of an unforeseen event that prohibited matching with vaccine-related data in the EHR) at any location in the 2014-2015 season (to assess influenza vaccine receipt after hospitalization).…”

Section: Survey Instrument and Proceduresmentioning

confidence: 99%

“…Using the validated Parent Attitudes about Childhood Vaccine (PACV) survey [19][20][21] (modified for influenza vaccination), researchers of a recent investigation found that parental vaccine hesitancy was associated with declination of the influenza vaccine in the pediatric emergency department (PED). 22 Additional evaluation of vaccine hesitancy among parents of high-risk children during hospitalization and its role in influenza vaccine declination in the hospital setting is needed.…”

mentioning

confidence: 99%

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Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

Hofstetter

Simon

Lepere³

et al. 2018

Hospital Pediatrics

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Parents frequently decline the influenza vaccine for their child during hospitalization. In this study, we aimed to assess the role of vaccine hesitancy in these declinations. METHODS: This cross-sectional survey study was conducted among English-speaking parents of influenza vaccineeligible children who were hospitalized between October 2014 and April 2015. Between July 2015 and September 2015, parents were recruited via mail to complete the validated Parent Attitudes about Childhood Vaccines (PACV) survey (modified for influenza vaccination). PACV scores (0-100 scale) were dichotomized into scores of $50 (hesitant) and ,50 (nonhesitant). The primary outcome was parental declination of the influenza vaccine for their child during hospitalization. A secondary outcome was the declination reason documented during hospitalization. The main independent variable was parental vaccine hesitancy status, determined by the PACV score. Multivariable logistic regression was used to examine the association between vaccine hesitancy and influenza vaccine declination, adjusting for sociodemographic, visit, and clinical characteristics. The relationship between vaccine hesitancy and declination reason was also explored. RESULTS: Of 199 parents (18% response rate), 24% were vaccine hesitant and 53% declined the influenza vaccine for their child during hospitalization. Vaccine hesitancy (versus nonhesitancy) was associated with declining influenza vaccination (adjusted odds ratio: 6.4; 95% confidence interval: 2.5-16.5). The declination reason differed by vaccine hesitancy status, with a higher proportion of parents who were hesitant versus nonhesitant reporting "vaccine concern" or "vaccine unnecessary." CONCLUSIONS: Vaccine hesitancy was prevalent in this limited sample of parents of hospitalized children and associated with influenza vaccine declination. Additional investigation in a large, diverse, prospectively recruited cohort is warranted given the potential sampling bias present in this study.

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Survey Instrument and Proceduresmentioning

confidence: 99%

mentioning

confidence: 99%

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Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

Hofstetter

Simon

Lepere³

et al. 2018

Hospital Pediatrics

Self Cite

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“…With vaccine hesitancy on the rise, parents are seeking reliable information helping them to distinguish fact from fiction (Downs et al, 2008, Strelitz et al, 2015). The active involvement of parents in matters of vaccine prevention may contribute towards restoring trust (Oyo-Ita et al, 2011, Fadda et al, 2015, Odone et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Educating parents about the vaccination status of their children: A user-centered mobile application

Seeber

Conrad

Hoppe

et al. 2017

Preventive Medicine Reports

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Parents are often uncertain about the vaccination status of their children. In times of vaccine hesitancy, vaccination programs could benefit from active patient participation. The Vaccination App (VAccApp) was developed by the Vienna Vaccine Safety Initiative, enabling parents to learn about the vaccination status of their children, including 25 different routine, special indication and travel vaccines listed in the WHO Immunization Certificate of Vaccination (WHO-ICV). Between 2012 and 2014, the VAccApp was validated in a hospital-based quality management program in Berlin, Germany, in collaboration with the Robert Koch Institute. Parents of 178 children were asked to transfer the immunization data of their children from the WHO-ICV into the VAccApp. The respective WHO-ICV was photocopied for independent, professional data entry (gold standard). Demonstrating the status quo in vaccine information reporting, a Recall Group of 278 parents underwent structured interviews for verbal immunization histories, without the respective WHO-ICV. Only 9% of the Recall Group were able to provide a complete vaccination status; on average 39% of the questions were answered correctly. Using the WHO-ICV with the help of the VAccApp resulted in 62% of parents providing a complete vaccination status; on average 95% of the questions were answered correctly. After using the VAccApp, parents were more likely to remember key aspects of the vaccination history. User-friendly mobile applications empower parents to take a closer look at the vaccination record, thereby taking an active role in providing accurate vaccination histories. Parents may become motivated to ask informed questions and to keep vaccinations up-to-date.

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Cost-effectiveness of Strategies for Offering Influenza Vaccine in the Pediatric Emergency Department

et al. 2018

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IMPORTANCE Influenza is a significant public health burden, causing morbidity and mortality in children, yet vaccination rates remain low. Vaccination in the pediatric emergency department (PED) setting may be beneficial but, to date, has not been proven to be cost-effective.OBJECTIVE To compare the cost-effectiveness of 4 strategies for PED-based influenza vaccine: offering vaccine to all patients, only to patients younger than 5 years, only to high-risk patients (all ages), or to no patients. DESIGN, SETTING, AND PARTICIPANTSUsing commercial decision analysis software, a cost-effectiveness analysis was performed from January 1, 2016, to June 1, 2017, to compare influenza vaccine strategies at a tertiary, urban, freestanding PED with an estimated 60 000 visits per year among a hypothetical cohort of children visiting the above PED during influenza season. Sensitivity analyses estimated the effect of uncertainties across a variety of input variables (eg, influenza prevalence, vaccine price and effectiveness, and costs of complications). MAIN OUTCOMES AND MEASURESThe primary outcomes were cost and incremental cost-effectiveness ratio in dollars per influenza case averted. Secondary outcomes included total societal costs, hospitalizations and deaths averted, and quality-adjusted life-years gained.

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Parental vaccine hesitancy and acceptance of seasonal influenza vaccine in the pediatric emergency department

Abstract: Administration of the PACV in the PED is feasible, and higher PACV scores in this setting are associated with increased influenza vaccine refusal.

Cited by 72 publications

References 27 publications

Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

Parental Vaccine Hesitancy and Declination of Influenza Vaccination Among Hospitalized Children

Educating parents about the vaccination status of their children: A user-centered mobile application

Cost-effectiveness of Strategies for Offering Influenza Vaccine in the Pediatric Emergency Department

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