Intent to obtain pediatric influenza vaccine among mothers in four middle income countries |
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| Institution: | 1. Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA;2. Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines;3. Department of Epidemiology & Control of Infectious Diseases, Institute of Public Health, Tirana, Albania;4. Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA;5. Abt Associates, Inc., Atlanta, GA, USA;6. The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan;7. Sustainable Sciences Institute, Managua, Nicaragua;8. Hospital Infantil Manuel de Jesús Rivera, Ministry of Health, Managua, Nicaragua;9. Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua;10. Section of Infectious Diseases, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA;11. Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA;1. University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;2. Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines;3. National Institute for Health and Welfare, Helsinki, Finland;4. Research Institute for Tropical Medicine, Manila, Philippines;5. University of Colorado, Boulder, CO, USA;6. Center for Global Health, Colorado School of Public Health, Aurora, CO, USA;1. Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa;2. Department of Science/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Faculty of Health Science, Johannesburg, South Africa;3. Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa;4. Family Center for Clinical Research Unit, Faculty of Medicinewith Ubuntu, Department of Paediatrics and ChildMedicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;5. Division of AIDS National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States;1. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia;2. Instituto Nacional de Pediatria, Unidad de Apoyo a la Investigación Clínic, Mexico City, Mexico;3. Research Institute for Tropical Medicine, Medical Department, Alabang, Muntinlupa, Philippines;4. Sanofi Pasteur, Biostatistics, Marcy l’Etoile, France;5. Sanofi Pasteur, Global Clinical Science, Swiftwater, PA, USA;6. Sanofi Pasteur, Global Clinical Science, Singapore, Singapore;1. Department of Epidemiology, School of Public Health, University of Michigan, USA;2. St. Jude Center of Excellence for Influenza Research and Surveillance, Memphis, TN, USA;3. Centers of Excellence for Influenza Research and Surveillance (CEIRS), USA;4. Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA;5. Center for Research on Influenza Pathogenesis (CRIP), New York, NY, USA;6. Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua;7. Sustainable Sciences Institute, Managua, Nicaragua;8. Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua;1. National Institute of Infectious Diseases, Japan;2. Kitasato Institute for Life Sciences, Japan;1. Research Institute for Tropical Medicine, 9002 Research Drive, Filinvest Corporate City, Alabang, Muntinlupa City, Manila 1781, Philippines;2. PATH, PO Box 900922, Seattle, WA 98109, USA;3. US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA;4. Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok 10400, Thailand;5. Chengdu Institute of Biological Products Co., Ltd., 379, 3rd, Jinhua Road, Jinjiang District, Chengdu 61002, China |
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| Abstract: | BackgroundDespite a large burden of influenza in middle income countries, pediatric vaccination coverage remains low. The aims of this study were to (1) describe mothers’ knowledge and attitudes about influenza illnesses and vaccination, and (2) identify characteristics associated with mothers’ intent to vaccinate their child.MethodsFrom 2015 to 2017, infants 0–11 months old in Nicaragua, Philippines, Jordan, and Albania were enrolled from community settings and hospitals. Interviewers administered a questionnaire to their mothers. Mothers of infants aged 6–11 months rated their intention (small-to-moderate vs. large chance) to accept pediatric vaccination if it was offered at no-cost. The importance of knowledge, attitudes, and sociodemographic characteristics in predicting influenza vaccination intention was measured as the mean decrease in Gini index when that factor was excluded from 1000 decision trees in a random forest analysis.ResultsIn total, 1,308 mothers were enrolled from the community setting and 3,286 from the hospital setting. Prevalence of at least some knowledge of influenza illness ranged from 34% in Philippines to 88% in Albania (in the community sample), and between 23% in Philippines to 88% in Jordan (in the hospital sample). In the community sample, most mothers in Albania (69%) and Philippines (58%) would accept the influenza vaccine, and these proportions were higher in the hospital sample for all countries except Albania (48%) (P < 0.0001). Perceived vaccine safety (mean decrease in Gini index = 61) and effectiveness (55), and perceived knowledge of influenza vaccine (45) were the most important predictors of influenza vaccination intention in models that also included country and community versus hospital sample.ConclusionIntent to vaccinate infants aged 6–11 months in four middle income countries was tied primarily to knowledge of the vaccine and perceptions of vaccine safety and effectiveness. These findings were noted among mothers interviewed in the community and mothers of recently hospitalized infants. |
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| Keywords: | Influenza vaccine Infant Vaccine refusal Developing countries |
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