One-Third of Asthmatic Kids Don't Get Flu Vaccine


DENVER – At least 30% of asthmatic children do not get vaccinated against influenza, according to the results of a nationwide survey of parents.

Additionally, parents who choose not to have their children immunized against influenza are significantly less likely to perceive colds and flu as important triggers of their child's asthma than are parents who do have their children vaccinated, suggesting an educational opportunity for health care providers. “Changing vaccination behavior will require educational messages that help shift parental concerns from the impact of the vaccine to the impact of influenza itself,” Dr. Toby C. Lewis said.

The survey was part of the C.S. Mott Children's Hospital National Poll on Children's Health (NPCH), a Web-based survey of national public opinion and perceptions regarding major health care issues for U.S. children.

It is administered to approximately 2,000 households, with data weighted to reflect U.S. census demographic distribution. Among 1,621 parents who responded to the survey during Aug. 13–Sept. 7, 2010, 237 (15%) parents of children aged 2–17 years with diagnosed asthma were identified. The parents were 50% white, 24% black, 20% Hispanic, and 6% other, from a broad spectrum of economic backgrounds.

A total of 70% reported that their children had been vaccinated against seasonal or pandemic H1N1 influenza during the 2009–2010 winter season, and 65% indicated that they planned to have their child vaccinated against influenza in the upcoming (2010–2011) season.

There were no significant differences between the asthmatic children who were and were not vaccinated in 2009–2010 with respect to household income, race/ethnicity, parental education, child's age, child's sex, or proportion with public insurance, reported Dr. Lewis, a pediatric pulmonologist at C.S. Mott Children's Hospital, Ann Arbor, Mich.

However, parents who did not vaccinate their children against influenza were significantly less likely than those who did vaccinate to indicate that getting a viral infection was “a very important” trigger of their child's asthma (47% vs. 72%).

There were no significant differences in their views about other asthma triggers such as outdoor or indoor allergies, tobacco smoke, or exercise.

On the flip side, nonvaccinating parents were significantly more likely to be concerned about vaccine side effects (60% vs. 30%) and about getting the flu from the vaccine (44% vs. 13%). The survey did not ask parents specifically what “side effects” they were concerned about, Dr. Lewis noted.

Also significantly different was who influenced their decision to vaccinate, with the child's health care provider indicated by 84% of vaccinating parents, compared with just 22% of nonvaccinating parents. “Child's school” was endorsed by 45% vs. 11%, respectively.

Dr. Lewis sees that 22% as a somewhat positive sign, suggesting that even some parents who are hesitant to vaccinate still trust their child's health care provider.

“If we can help parents understand the risks of influenza better, we may be able to help drive behavior. I think it's also important to tailor educational messages to the parents' specific concern,” she said in an interview.

She advised physicians not to berate parents who have expressed hesitancy about vaccination, but rather to try to create an alliance and communicate the health message about the benefits of vaccination.

And, she added, even if the parent doesn't seem receptive at first, “Don't give up!”

'If we can help parents understand the risks of influenza better, we may be able to help drive behavior.'

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