Factors Affecting Acceptance and Intention to Receive Pandemic Influenza A H1N1 Vaccine among Primary School Children: A Cross-Sectional Study in Birmingham, UK
UK pandemic influenza strategy focused on vaccination of high risk groups, although evidence shows that school-age children have the highest infection rates. Vaccination of children might be an additional strategy. We undertook a cross-sectional study amongst 149 parents of primary school children aged 4–7 years in Birmingham, UK to quantify intention to accept pandemic influenza vaccine and identify factors affecting uptake. Ninety-one (61.1%, 95% CI 52.8, 68.9) had or would accept vaccine for their child. The most common reasons for declining vaccine were concerns about safety (58.6% reported this), side effects (55.2%), or believing their child had already had swine flu (12.1%). Parents of nonwhite ethnicity (OR 2.4 (1.1, 5.0)) and with asthmatic children (OR 6.6 (1.4, 32.1)) were significantly more likely to accept pandemic vaccine, as were those whose children had ever received seasonal vaccine and those who believed swine flu to be a serious threat (OR 4.2 (1.9, 9.1)). Parents would be more likely to accept vaccination if they received a letter of invite, if the government strongly encouraged them, if it were administered at school, and if it were more thoroughly tested. Accurate media portrayal of safety of the vaccine during future pandemics will be essential. 1. Introduction The swine flu (H1N1) pandemic was confirmed on June 11th, 2009 by the World Health Organisation (WHO). The WHO declared the pandemic over by August 10th, 2010 [1], by which time 214 countries had reported laboratory confirmed cases, which included 18？449 deaths [2]. In contrast to seasonal influenza epidemics, in the 2009 H1N1 pandemic, younger age groups were disproportionately affected compared with older age groups [3]. A large proportion of older adults had preexisting natural immunity, probably due to HIN1 strains circulating in earlier decades [4]. Children under 5 years of age were most likely to be hospitalised if they contracted the H1N1 virus, and they also had high rates of admission to critical care with some fatalities [5]. In order to tackle the pandemic, plans worldwide were based on a vaccination programme and education [6]. In the UK, the vaccination programme officially started October 14th, 2009, with those in the “at risk” categories being offered the vaccination first. In December 2009, this was extended to children between the ages of six months and five years because of their increased level of risk [7]. However, sero-epidemiological studies based on the first wave of the pandemic showed that the rates of infection were actually the highest amongst
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