Willingness to Vaccinate Children Against Influenza after the Coronavirus Disease 2019 Pandemic

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¹The Pediatric Research in Emergency Therapeutics (PRETx) Program, Division of Emergency Medicine, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute
²Division of Pediatric Emergency Medicine, Children's Medical Center of Dallas
³Division of Critical Care, Department of Pediatrics, St. Marianna University School of Medicine
⁴Division of Pediatric Emergency Medicine, Children's Healthcare of Atlanta, Emory School of Medicine
⁵Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, USC Keck School of Medicine
⁶Emergency Department, University Children's Hospital Zurich
⁷Seattle Children's Hospital, and University of Washington School of Medicine
⁸Pediatric Emergency Unit, Hospital Sant Joan de Déu Barcelona
⁹Pediatric Emergency Unit, Shamir Medical Center, and Sackler Faculty of Medicine
¹⁰Pediatric Emergency Unit, Inselspital University Hospital of Bern
¹¹Pediatric Emergency Unit, Hospital for Sick Children and University of Toronto
¹²Pediatric Emergency Unit, Pediatric Institute of Italian part of Switzerland
¹³Pediatric Emergency Unit, Jim Pattison Children's Hospital, and University of Saskatchewan
¹⁴Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, and Faculty of Medicine, University of Geneva
¹⁵Pediatrics and Emergency Medicine, Alberta Children's Hospital and University of Calgary
¹⁶Department of Emergency Medicine, Mary Bridge Children's Hospital
¹⁷Department of Pediatrics, Faculty of Medicine & Dentistry, Women and Children's Health Research Institute, University of Alberta

Seasonal influenza is a major global health problem, responsible for thousands of deaths every year, including among children. As the global coronavirus 2019 (COVID-19) pandemic enters influenza epidemic season in the Northern hemisphere, vaccination against influenza is a public health goal.

We aimed to determine factors associated with parental willingness to vaccinate their children against influenza in 2021, especially those who did not vaccinate against influenza the prior year. We employed a global survey of caregivers accompanying their children 1-19 years old in 17 pediatric Emergency Departments (ED) in 6 countries between March 27 and June 30, 2020. The survey included demographic information, vaccination history and global attitudes to vaccination, as well as concern about COVID-19 illness of the child and caregiver during the ED visit.

Of 2422 surveys, 1314 (54.2%) caregivers stated they plan to vaccinate their child against influenza next year, an increase of 15.8% from the previous year. Of 1459 caregivers who did not vaccinate their children last year, 418 (28.6%) plan to do so next year. Factors predicting willingness to change attitude and vaccinate included child`s up-to-date vaccination status (aOR 2.03, 95% CI 1.29-3.32, P=.003); caregivers` influenza vaccine history (aOR 3.26, 95% CI 2.41-4.40, P< .010), and level of concern their child had COVID-19 (aOR 1.09, 95% CI 1.01-1.17, P=.022).

Changes in risk perception due to COVID-19 and previous vaccination may serve to influence decision-making among caregivers regarding influenza vaccination. To promote influenza vaccination among children, global public health programs can leverage this information.