Parental willingness for children′s influenza vaccination after COVID-19 epidemic among 1 to 18 years children in urban Shanghai

  Objective   To investigate parental willingness for their children′s influenza vaccination and its influencing factors after coronavirus disease 2019 (COVID-19) epidemic and to provide evidences for improving influenza vaccination rate in children.

  Methods  Using stratified cluster random sampling, we recruited 2 554 children aged 1 – 18 years at 12 kindergartens, 4 primary and 5 middle schools and among attendees of vaccination clinics in an urban district of Shanghai; an online survey was conducted among the parents of the selected children with a self-designed questionnaire on family status, the awareness of influenza vaccine, their children′s influenza vaccination in 2020, and the intention for their children′s vaccination in 2021 influenza season during June 2021. Descriptive statistics and multivariate logistic regression were adopted in data analyses.

  Results  Complete information were collected from 98.85% (2 448) of the parents. The reported influenza vaccination rate was 51.59% among the respondents′ children in 2020 influenza season (September 2020 – January 2021) and the proportion of the respondents reporting the willingness to have their children′s influenza vaccination in 2021 influenza season was 58.66%. The results of multivariate logistic regression analysis showed that the influencing factors for the children′s influenza vaccination in 2020 included: children′s age (compared to the ages of 1 – 3 years: odds ratio OR_{4 – 6} = 7.966, 95% confidence interval 95% CI: 5.410 – 11.729; OR_{7 – 11} = 0.407, 95% CI: 0.282 – 0.587; and OR_{12 – 18} = 0.106, 95% CI: 0.066 – 0.169), parent-child relationship (father vs. mother: OR = 1.505, 95% CI: 1.149 – 1.973). The influencing factors for parents′ willingness to have their children being vaccinated in 2021 influenza season included: parent′s willingness for the vaccination of himself/herself (yes vs. no: OR = 12.301, 95% CI: 9.976 – 15.170), accepting the recommendation in national immunization plan (yes vs. no: OR = 2.662, 95% CI: 1.910 – 3.709), participating in COVID-19 epidemic prevention and control (yes vs. no: OR = 1.449, 95% CI: 1.082 – 1.940), being local resident (yes vs. no: OR = 0.702, 95% CI: 0.531 – 0.928), being worried about vaccine safety (yes vs. no: OR = 0.627, 95% CI: 0.465 – 0.845 and yes vs. uncertainly: OR = 0.682, 95% CI: 0.478 – 0.975), with relatives or friends ever experiencing COVID-19 infection (yes vs. no: OR = 0.411, 95% CI: 0.192 – 0.878), and children′s age (compared to the ages of 1 – 3 years: OR_{7 – 11} = 0.384, 95% CI: 0.240 – 0.615, OR_{12 – 17} = 0.289, 95% CI: 0.173 – 0.484).

  Conclusion  For 1 – 18 years old children in urban Shanghai, parental willingness for children′s influenza vaccination was mainly related to parents′ cognition on the vaccine, vaccine policy and family situation after COVID-19 epidemic. The results suggest that relevant education should be conducted among the children′s parents for promoting childhood influenza vaccination.