A survey of children's preferences for influenza vaccine attributes☆
Introduction
Seasonal influenza is a contagious, vaccine-preventable, respiratory illness common among school-age children, who are more likely than any other age group to be infected with influenza, especially during the early portion of the seasonal epidemic [1], [2], [3]. Annual influenza vaccination is the most effective means of preventing influenza illness in children [4]. A universal pediatric influenza vaccination recommendation was adopted by the Advisory Committee on Immunization Practice (ACIP) in 2008. ACIP influenza vaccination recommendations have been in place since 2004 for children aged 6–24 months and since 2006 for children aged 24–59 months; yet during the 2008–2009 influenza season, the Centers for Disease Control and Prevention (CDC) found that only 32% of children aged 2–4 years, and 21% of children aged 5–17 years received an influenza vaccine [5]. Research has shown that key barriers to parental vaccination of children include the belief that the vaccine is ineffective, unsafe, or unnecessary [6], [7], [8], [9].
Two types of influenza vaccine options are currently available for children in the United States: the trivalent, inactivated vaccine (TIV), which is administered as an intramuscular injection, and the Ann Arbor strain live, attenuated influenza vaccine (LAIV), which is administered as an intranasal mist. Currently, there is only one licensed LAIV intranasal vaccine in the US, while there are several TIV products currently licensed. LAIV is approved for eligible children 2 years of age and older while some TIV formulations are approved for use in eligible children 6 months of age and older (TIV products differ with respect to eligible populations—the FDA approved labeling for each product should be consulted) [10].
While parents are key decision-makers regarding influenza vaccination for their children, children's perceptions and preferences may be useful to inform parent decisions and health care provider recommendations, thereby improving vaccination rates. Several studies have been conducted to investigate parents’ perceptions of pediatric influenza vaccine for their children, specifically with regard to decision-making for vaccinating their child [7], [8], [9], [11], [12]. These studies suggest that perceptions regarding vaccine efficacy and safety are key factors influencing parent decision-making. However, there is limited insight into children's knowledge, perceptions, and preferences for influenza vaccines. To our knowledge, no published studies have investigated perceptions or preferences for influenza vaccine attributes (i.e., features of the vaccine that would be important and understandable to children) from the perspective of children. The objective of this study was to examine children's preferences for select influenza vaccine attributes and the factors that influence their preferences.
Section snippets
Methods
We conducted a cross-sectional, internet-based survey during August and September 2009 to assess children's knowledge, experience, and perceptions of influenza vaccines and to quantify children's preferences for influenza vaccine attributes using conjoint analysis. The survey was administered to 544 children aged 8–12 years.
A two-step proportional quota sampling strategy was used to recruit the sample for this study (see Fig. 1). First, parents with a child between the ages of 8–12 years old
Results
A total of 1471 parents with children aged 8–12 were invited to complete the survey, and of these, 867 parents expressed interest. 544 parents had children who were eligible based on age and gender stratification goals, assented, and completed the survey (overall response rate of 37%). Missing data did not exceed 3% for any question. Sample characteristics of children and their parents can be found in Table 2. In line with our stratification goals, children were stratified almost equally by age
Discussion
There is a dearth of literature regarding children's perceptions and preferences for influenza vaccines. To our knowledge, no other studies have explored preferences for influenza vaccine attributes from the child's perspective. The results of the conjoint data supported the importance of efficacy and mode of administration, but in the conjoint analysis, mode was the most important driver followed by efficacy. This difference likely is the result of the limited range of efficacy tested in the
Acknowledgements
This study was sponsored by MedImmune, LLC, manufacturer of an influenza vaccine. Ms. Flood and Ms. Beusterien are employees of Oxford Outcomes. Dr. Rousculp, Ms. Ryan, and Dr. Mahadevia are employees of MedImmune. Dr. Block has received research grants from MedImmune, Sanofi, Novartis, and GlaxoSmithKline.
Conflict of interest: The authors have indicated that they have no other conflict of interest with regard to the content of this article.
The authors thank Drs. Christopher Ambrose, Seth
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Vaccine preferences and acceptance of older adults
2017, VaccineCitation Excerpt :Our results are in line with recent other studies that examine vaccine specific attributes in different Western populations. Studies on children [25–27], parents [28–32] and the general population [33] all show preferences for high vaccine effectiveness. In most studies, respondents significantly preferred minor side-effects or low chance on (severe) side-effects over high levels of side-effects, while in our study, mild side-effects did not affect vaccine decision-making [25,30–32,34].
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This study was sponsored by MedImmune, LLC. MedImmune was involved with the study design and data analysis, and MedImmune employees served as authors on the manuscript.