J Pediatr Infect Dis 2012; 07(02): 089-096
DOI: 10.3233/JPI-120344
Georg Thieme Verlag KG Stuttgart – New York

Parents' intentions and behavior regarding seasonal influenza vaccination for their children: A survey in child-care centers in Sydney, Australia

Maria Yui Kwan Chowa, b, Catherine Kinga, b, Robert Booya, b, c, d, Julie Leaska, b
  • aNational Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Sydney, Australia
  • bDiscipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
  • cSydney Emerging Infections and Biosecurity Institute, Sydney, NSW, Australia
  • dAcademic Unit of Child Health, Queen Mary University of London, London, UK

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Further Information

Publication History

09 June 2012

31 July 2012

Publication Date:
28 July 2015 (online)


The annual incidence of laboratory-confirmed influenza is usually between 2% and 20% in healthy children, and yet most parents surveyed do not intend to vaccinate their children. The aim of our study was to determine parental intentions and behavior regarding influenza vaccination for their children and to explore explanatory variables. We conducted a cross-sectional survey in 16 child-care centers in Sydney, Australia, between November and December 2009, just after the first wave of the 2009 influenza pandemic. Survey packets were distributed at the child-care centers and e-mails were sent to parents of children aged 6 months to 5 years, asking them to complete the questionnaire either on paper or over the web. The questions addressed knowledge, behavior, intentions and beliefs regarding seasonal influenza and vaccination. We analyzed the data by descriptive statistics as well as using both univariate and multivariate tests with logistic regression.

We received 431 completed questionnaires (response rate: 44%). Vaccination was chosen by 59% of respondents as a method for preventing influenza. 21% of parents were extremely or very concerned about the likelihood of their child contracting influenza. During 2009, 12% of children were offered seasonal influenza vaccine by a health-care professional, but only 8% received it. For the coming 2010 season, 22% of parents were planning to have their child vaccinated while 52% were unsure about vaccinating. Nearly half (45%) were "unsure" whether influenza vaccine is more of a risk for children than actually having influenza. About 60% were unsure whether or not the vaccine should be recommended for chronically ill children. The two strongest discouragers to vaccination were a parental perception that the vaccine was new and the requirement for annual vaccination. The strongest behavioral predictors for vaccination in 2009 were the offer of vaccination by a health-care professional (OR: 35.7, 95% CI: 13.2–90.9) and the perception that the vaccine is safe for children aged 1–5 years (OR: 27.8, 95% CI: 3.6–200.0).

Australian parents had limited knowledge about seasonal influenza vaccine, with almost half unsure about its safety for children. Health-care professionals are pivotal to promoting vaccination uptake, as parents considered them the most reliable source of information. Health-care professionals should be educated to provide up-to-date, accurate information to parents.