Study evaluates parents' reluctance to vaccinate asthmatic kids

The study was presented at the ATS 2011 International Conference in Denver.

"When school starts in the fall, and during the winter season, many parents start dreading the cold and flu season," said lead author Toby Lewis, MD, MPH, assistant professor of pediatric pulmonology at C.S. Mott Children's Hospital in Ann Arbor, Mich. "This is particularly true for parents of children with asthma, who recognize that 'a little cold' can quickly trigger an asthma attack. Fortunately, there is something that can be done to reduce the chances of getting sick from influenza, one of the common winter viruses, and that is getting a vaccination to help prevent this infection. "

Influenza vaccination is recommended for all children, but especially for children with asthma to help prevent asthma exacerbations or 'flares,'" Dr. Lewis added. "Despite this recommendation, vaccination rates remain low. The reasons for under-immunization are poorly understood."

To determine parental attitudes toward the flu vaccine, and learn the reasons why some parents do not have their asthmatic children vaccinated, the researchers conducted a national survey from August 13 -- Sept 7, 2010 of 1,621 parents; 237 parents indicated at least one child had asthma and were included in the final compilation of data.

"The parents included in the study were ethnically diverse and were from a broad spectrum of economic backgrounds," Dr. Lewis noted.

Of those surveyed, 70 percent reported that they vaccinated their child against seasonal or H1N1 influenza during the prior winter season (2009-2010), and 65 percentstated that they planned to have their child vaccinated against influenza in the upcoming season (2010-2011), indicating consistency in vaccination behavior. The study also found that parents who did not vaccinate their asthmatic children against influenza were less likely than those that did vaccinate indicate that getting a viral infection was a "very important" trigger of their child's asthma (53 percent vs. 72 percent), and were more likely to be concerned about vaccine side effects (60 percent vs. 26 percent) and getting sick from the vaccine itself (41 percent vs. 13 percent).

"Not surprisingly, parents who felt that their children were likely to experience an asthma attack when they got a respiratory infection were more likely to get their child vaccinated," Dr. Lewis said. "Worries about potential side effects of the vaccine emerged as an important factor for families who did not have their child vaccinated. The group as a whole indicated that their physician was an important source of health information for their family -- suggesting that physicians may have an opportunity to advise families about this important preventative measure."

The survey also identified exposures in addition to colds and flu that parents believe are most likely to trigger asthma attacks, including:

• exposure to smokers (73 percent);
• exposure to outdoor allergens such as pollen and weeds (81 percent);
• outdoor air quality/pollution levels (77 percent);
• exposure to indoor allergens such as dust mites and cockroaches (71 percent)
• contact with furry or hairy animals (48 percent); and,
• food(30 percent).

Dr. Lewis noted that the study provides helpful insight into the way families of children with asthma view influenza infection and the influenza vaccine.

"The results will help physicians, public health professionals and health educators tailor messages most effectively to this group of families," she said."We will continue to analyze our current survey results to better understand parent attitudes, and hope to work with colleagues to develop educational messages specifically designed for parents who have previously opted out of vaccinating their children against influenza -- for instance, highlighting stories from parents of children with asthma who did get their child vaccinated to help show a positive experience with influenza vaccination."

This study was funded by the C.S. Mott Children's Hospital National Poll on Children's Health Pediatric Faculty Participation Program, through the generosity of the University of Michigan Department of Pediatrics and Communicable Diseases.