Mabel S F Low1, Hweeyong Tan2, Mikael Hartman1, Clarence C Tam3, Cheehow Hoo2, Jiaqing Lim2, Simin Chiow2, Simin Lee2, Renzhi Thng2, Mingzhe Cai2, Yanru Tan2, Jingzhan Lock2. 1. Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore. 2. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore. 3. Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore 117549, Singapore; London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. Electronic address: clarence.tam@nus.edu.sg.
Abstract
PURPOSE: Seasonal influenza vaccination is recommended in children aged 6-59months, but little is known about child vaccination coverage and determinants in Asian settings. We report the results of a survey of knowledge, attitudes, practices, and determinants of child influenza vaccination in Singapore. METHODS: In December 2015-March 2016, we conducted a survey of 332 parents of children aged 6months to 5years attending pre-schools. We assessed child influenza vaccine coverage and parental knowledge, attitudes, and practices of child influenza vaccination. We used multivariable regression and structural equation models to identify factors associated with child influenza vaccination. RESULTS: Knowledge about influenza, perceived benefit of vaccination, and willingness to vaccinate were high. However, only 32% of children had ever received influenza vaccine, and only 15% in the past year. Factors independently associated with child influenza vaccination included: being recommended influenza vaccine by a child's doctor (prevalence ratio (PR)=2.47, 95% CI: 1.75-3.48); receiving influenza vaccine information from a private general practitioner (PR=1.47, 95% CI: 1.05-2.04); regularly receiving pre-travel influenza vaccine (PR=1.64, 95% CI: 1.19-2.25); higher willingness to vaccinate (PR=1.58, 95% CI:1.24-2.04 per unit increase in willingness score); and feeling well-informed about influenza vaccine (PR=1.44, 95% CI: 1.04-1.99). Parents who obtained influenza vaccine information from television were less likely to have vaccinated their child (PR=0.44, 95% CI: 0.23-0.85). Path analysis indicated that being recommended vaccination by a child's doctor increased willingness to vaccinate and self-efficacy (feeling well-informed about influenza vaccine). Median willingness-to-pay for a dose of influenza vaccine was SGD30 (interquartile range: SGD20-SGD50), and was higher in parents of vaccinated compared with unvaccinated children (SGD45vs SGD30, p=0.0012). CONCLUSION: Knowledge and willingness to vaccinate was high in this parent population, but influenza vaccine uptake in children was low. Encouraging medical professionals to recommend vaccination of eligible children is key to improving uptake.
PURPOSE: Seasonal influenza vaccination is recommended in children aged 6-59months, but little is known about child vaccination coverage and determinants in Asian settings. We report the results of a survey of knowledge, attitudes, practices, and determinants of child influenza vaccination in Singapore. METHODS: In December 2015-March 2016, we conducted a survey of 332 parents of children aged 6months to 5years attending pre-schools. We assessed child influenza vaccine coverage and parental knowledge, attitudes, and practices of child influenza vaccination. We used multivariable regression and structural equation models to identify factors associated with child influenza vaccination. RESULTS: Knowledge about influenza, perceived benefit of vaccination, and willingness to vaccinate were high. However, only 32% of children had ever received influenza vaccine, and only 15% in the past year. Factors independently associated with child influenza vaccination included: being recommended influenza vaccine by a child's doctor (prevalence ratio (PR)=2.47, 95% CI: 1.75-3.48); receiving influenza vaccine information from a private general practitioner (PR=1.47, 95% CI: 1.05-2.04); regularly receiving pre-travel influenza vaccine (PR=1.64, 95% CI: 1.19-2.25); higher willingness to vaccinate (PR=1.58, 95% CI:1.24-2.04 per unit increase in willingness score); and feeling well-informed about influenza vaccine (PR=1.44, 95% CI: 1.04-1.99). Parents who obtained influenza vaccine information from television were less likely to have vaccinated their child (PR=0.44, 95% CI: 0.23-0.85). Path analysis indicated that being recommended vaccination by a child's doctor increased willingness to vaccinate and self-efficacy (feeling well-informed about influenza vaccine). Median willingness-to-pay for a dose of influenza vaccine was SGD30 (interquartile range: SGD20-SGD50), and was higher in parents of vaccinated compared with unvaccinated children (SGD45vs SGD30, p=0.0012). CONCLUSION: Knowledge and willingness to vaccinate was high in this parent population, but influenza vaccine uptake in children was low. Encouraging medical professionals to recommend vaccination of eligible children is key to improving uptake.
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