# Family matters: influenza vaccination uptake and associated factors in children aged 6 months–6 years

## TL;DR

This study finds that parental vaccination status strongly influences whether young children receive the influenza vaccine, with higher rates among children from families with higher socioeconomic status.

## Contribution

The study identifies parental vaccination as the strongest predictor of child influenza vaccination, suggesting a family-centered approach could improve vaccination rates.

## Key findings

- Parental vaccination status was the strongest predictor of child influenza vaccination (OR 41.86).
- Children from higher socioeconomic backgrounds were more likely to be vaccinated (OR 2.29).
- Parental smoking was associated with lower vaccination rates in children (OR 0.80 for two smoking parents).

## Abstract

Influenza poses significant health risks to young children, who are more vulnerable to severe complications. Despite effective vaccines, influenza vaccination rates among children are suboptimal. This study aims to identify the key predictors of influenza vaccine uptake among children aged 6 months to 6 years.

A retrospective cohort study used data from Maccabi Healthcare Services in Israel. Electronic medical records provided demographics, vaccination status, comorbidities, healthcare use, and parental vaccination. Logistic regression identified factors associated with influenza vaccine uptake.

Among 293,078 children aged 6 months to 6 years during the 2022–2023 flu season, only 41,885(14.3%) received the influenza vaccine. Patients with higher socioeconomic status were more often vaccinated (51.1% vs. 26.4%, p < 0.001). Parental smoking was inversely associated with more non-smoking parents in the vaccinated group (72.6%) compared to the unvaccinated (66.1%, p < 0.001). The factor most strongly associated with child vaccination was parental vaccination status (OR 41.86, 95% CI [40.54–43.22], p < 0.001). Other significant predictors were higher socioeconomic status (OR = 2.29, 95% CI [2.15–2.43], p < 0.001) and frequent healthcare utilization, such as a high rate of doctor visits during the preceding year (four or more visits: OR = 2.09, 95%, CI [1.90–2.29], p < 0.001). Conversely, children from minority populations and those with parents who smoked were less likely to be vaccinated (one smoking parent, OR = 0.85, 95% CI [0.82–0.88], p < 0.001; and two smoking parents, OR = 0.80, 95% CI [0.74–0.87], p < 0.001). For children aged 18 months to 6 years (n = 247,381), vaccination in the previous year was also a significant predictor (OR 10.35, 95% CI [9.97–10.74]).

The study highlights the critical role of parental vaccination status in influencing child vaccination rates. A family-centered approach to vaccination promotion can enhance vaccine coverage among young children, contributing to better health outcomes and robust community immunity.