J Korean Med Sci.  2017 Feb;32(2):204-211. 10.3346/jkms.2017.32.2.204.

A Survey of Parental Perception and Pattern of Action in Response to Influenza-like Illness in Their Children: Including Healthcare Use and Vaccination in Korea

• Hwang JH
• Lim CH
• Kim DH
• Eun BW
• Jo DS
• Song YH
• Kim YK

• KMID: 2364163
• DOI: http://doi.org/10.3346/jkms.2017.32.2.204

Abstract

Seasonal influenza is a significant cause of morbidity and mortality of children in Korea. However, few data are available on parental perception and action toward childhood influenza. This study aimed to characterize parental perception and patterns of action in response to influenza and influenza-like illnesses (ILIs), including vaccination and healthcare use. This prospective study involved a random survey of parents whose children were aged 6-59 months. The survey was conducted in October 2014. The study included 638 parents of 824 children younger than 6 years. Most parental information of influenza came from mass media (28.2%) and social media (15.5%). The factor that most often motivated parents to vaccinate their children against influenza was promotion of the government or mass media (36.6%). Negative predictors of immunization included safety concerns about influenza vaccination (28.1%) and mistrust in the vaccine's effectiveness (23.3%). Therefore, correct information about influenza and vaccination from mass media will be one of the cornerstones for implementing a successful childhood immunization program and reducing morbidity and mortality in Korea. Furthermore, to enroll younger children in vaccination programs, and to minimize coverage gaps, public concerns about vaccine safety should be resolved. The demographic data in the present study will be used to provide a deeper insight into a parental perception and will help health care providers increase influenza immunization rate.

Keyword

Survey and Questionnaires; Influenza; Human; Influenza Vaccines; Children

MeSH Terms

Child*
Delivery of Health Care*
Health Personnel
Humans
Immunization
Immunization Programs
Influenza Vaccines
Influenza, Human
Korea*
Mass Media
Mortality
Parents*
Prospective Studies
Seasons
Social Media
Vaccination*
Influenza Vaccines

Figure

• 

  Fig. 1 Survey results. (A) Most effective ways to prevent influenza. (B) Sources of information on influenza and vaccination. (C) Motivating factors for influenza vaccination. (D) Influenza vaccination status in children. (E) Influenza vaccination status in parents. (F) Decision making in hospital visits. (G) Type of visiting hospital during the daytime. (H) Type of visiting hospital during the nighttime. ER = emergency room.

• 

  Fig. 2 Reasons for refusal of the influenza vaccination in parents and children.

Reference

1. Ki HO, Kim IH, Cho EH, Kang MG, Chu H, Lee JY. Korean influenza sentinel surveillance report, 2014–2015 [Internt]. accessed on 25 August 2016. Available at http://www.cdc.go.kr/CDC/info/CdcKrInfo0301.jsp?menuIds=HOME001-MNU1132-MNU1138-MNU0037MNU1380&q_type=&year=2015&cid=66230&pageNum=%20.

2. Longini IM Jr, Koopman JS, Monto AS, Fox JP. Estimating household and community transmission parameters for influenza. Am J Epidemiol. 1982; 115:736–751.

3. Monto AS, Koopman JS, Longini IM Jr. Tecumseh study of illness. XIII. Influenza infection and disease, 1976-1981. Am J Epidemiol. 1985; 121:811–822.

4. Fox JP, Cooney MK, Hall CE, Foy HM. Influenzavirus infections in Seattle families, 1975–1979. II. Pattern of infection in invaded households and relation of age and prior antibody to occurrence of infection and related illness. Am J Epidemiol. 1982; 116:228–242.

5. Monto AS, Davenport FM, Napier JA, Francis T Jr. Effect of vaccination of a school-age population upon the course of an A2-Hong Kong influenza epidemic. Bull World Health Organ. 1969; 41:537–542.

6. American Academy of Pediatrics. Committee on Infectious Diseases. Influenza. In : Kimberlin DW, Brady MT, Jackson MA, Long SS, editors. Red Book: 2015 Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics;2015. p. 482–492.

7. Champion VL, Skinner CS. The health belief model. In : Glanz K, Rimer BK, Viswanath K, editors. Health Behavior and Health Education: Theory, Research, and Practice. 4th ed. San Francisco, CA: Jossey-Bass;2002. p. 45–66.

8. Ansan City Hall (KR). Population statistics by age group in Ansan [Internet]. accessed on 18 October 2016. Available athttps://stat.iansan.net/new/Population.jsp?menuId=20002001.

9. Ansan City Hall (KR). Statistical information on social welfare services in Ansan [Internet]. accessed on 18 October 2016. Available at https://stat.iansan.net/new/Welfare.jsp?menuId=20002004.

10. Statistics Korea. Population statistics by age group in Jeonju [Internet]. accessed on 18 October 2016. Available at http://stat.kosis.kr/statHtml_host/statHtml.do?orgId=711&tblId=DT_M0105Y&dbUser=NSI_IN_711.

11. Statistics Korea. Statistical information on social welfare services in Jeonju [Internet]. accessed on 18 October 2016. Available at http://stat.kosis.kr/statHtml_host/statHtml.do?orgId=711&tblId=DT_YB1223_1&dbUser=NSI_IN_711.

12. Akis S, Velipasaoglu S, Camurdan AD, Beyazova U, Sahn F. Factors associated with parental acceptance and refusal of pandemic influenza A/H1N1 vaccine in Turkey. Eur J Pediatr. 2011; 170:1165–1172.

13. Daley MF, Crane LA, Chandramouli V, Beaty BL, Barrow J, Allred N, Berman S, Kempe A. Influenza among healthy young children: changes in parental attitudes and predictors of immunization during the 2003 to 2004 influenza season. Pediatrics. 2006; 117:e268–77.

14. Elliott C, Farmer K. Immunization status of children under 7 years in the Vikas Nagar area, North India. Child Care Health Dev. 2006; 32:415–421.

15. Statista (US). Global internet penetration rates in 2014, by country [Internet]. accessed on 18 October 2016. Available at https://www.statista.com/statistics/470934/global-internet-penetration-rates-by-country/.

16. Statista (US). Average internet speed by country as of 1st quarter 2016 (in Mbps) [Internet]. accessed on 18 October 2016. Available at https://www.statista.com/statistics/204952/average-internet-connection-speed-by-country/.

17. Omer SB, Salmon DA, Orenstein WA, deHart MP, Halsey N. Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. N Engl J Med. 2009; 360:1981–1988.

18. Baxter R, Bakshi N, Fireman B, Lewis E, Ray P, Vellozzi C, Klein NP. Lack of association of Guillain-Barré syndrome with vaccinations. Clin Infect Dis. 2013; 57:197–204.

19. Vellozzi C, Iqbal S, Broder K. Guillain-Barre syndrome, influenza, and influenza vaccination: the epidemiologic evidence. Clin Infect Dis. 2014; 58:1149–1155.

20. Vellozzi C, Iqbal S, Stewart B, Tokars J, DeStefano F. Cumulative risk of Guillain-Barré syndrome among vaccinated and unvaccinated populations during the 2009 H1N1 influenza pandemic. Am J Public Health. 2014; 104:696–701.

21. Verity C, Stellitano L, Winstone AM, Stowe J, Andrews N, Miller E. Pandemic A/H1N1 2009 influenza vaccination, preceding infections and clinical findings in UK children with Guillain-Barré syndrome. Arch Dis Child. 2014; 99:532–538.

22. Rachiotis G, Mouchtouri VA, Kremastinou J, Gourgoulianis K, Hadjichristodoulou C. Low acceptance of vaccination against the 2009 pandemic influenza A(H1N1) among healthcare workers in Greece. Euro Surveill. 2010; 15:19486.

23. Salmon DA, Pan WK, Omer SB, Navar AM, Orenstein W, Marcuse EK, Taylor J, deHart MP, Stokley S, Carter T, et al. Vaccine knowledge and practices of primary care providers of exempt vs. vaccinated children. Hum Vaccin. 2008; 4:286–291.

24. Hemingway CO, Poehling KA. Change in recommendation affects influenza vaccinations among children 6 to 59 months of age. Pediatrics. 2004; 114:948–952.

25. Eastwood K, Durrheim DN, Jones A, Butler M. Acceptance of pandemic (H1N1) 2009 influenza vaccination by the Australian public. Med J Aust. 2010; 192:33–36.

26. Leo HL, Clark SJ, Butchart AT, Singer DC, Clark NM, Davis MM. 2009 seasonal and H1N1 influenza vaccination compliance in asthmatic children and adults. J Allergy Clin Immunol. 2010; 126:166–168.

27. Fiebach NH, Viscoli CM. Patient acceptance of influenza vaccination. Am J Med. 1991; 91:393–400.

28. Poehling KA, Speroff T, Dittus RS, Griffin MR, Hickson GB, Edwards KM. Predictors of influenza virus vaccination status in hospitalized children. Pediatrics. 2001; 108:E99.