Attitude towards EV71 vaccination and its influential factors among parents of children less than six years old in Songjiang district of Shanghai

Objective To examine the cognition of hand-foot-and-mouth disease (HFMD) and enterovirus 71 (EV71) vaccination among the parents of the children aged under 6 years and the parents' willingness to have their children vaccinated with EV71 vaccine. Methods A self-designed questionnaire survey was performed among 1 277 parents with children less than 6 years old selected with stratified random sampling from 6 urban and rural communities in Songjiang district of Shanghai between July and September 2015.Multivariate logistic regression was used to analyze factors associated with the parents' willingness for their children's EV71 vaccination. Results Among the parents surveyed, 26.32% and 16.22% had heard about EV71 infection and vaccination and 52.16% agreed to their children having EV71 vaccination.The main reason for the parents' refusal for their children receiving EV71 vaccination was the safety of the vaccine.Most of the parents agreed with EV71 inoculation in the public and hoped that EV71 vaccination could be included in the planned immunization program and got financial support from the government.The results of multivariate logistic analysis showed that the parents with registered permanent residence in Shanghai, with small children in kindergarten, and with children having HFMD history had willingness for their children's EV71 vaccination, with the odds ratio(OR) of 0.651(95% confidence interval95%CI=0.479-0.884), 0.737 (95%CI=0.563-0.965), and OR of 0.528 (95%CI=0.349-0.798);whereas, the parents with high school education, having the knowledge about the significance of EV71 vaccination, and considering EV71 being effective in HFMD prevention had higher willingness for their children's EV71 vaccination. Conclusion The parents of children aged less than 6 years in Shanghai had low knowledge about EV71 vaccination and the parents' willingness for EV71 inoculation of their children was influenced by registered residence, education level, knowledge about EV71 infection and vaccination of themselves and whether their children being in kindergarten and having HFMD history.