'Echo chamber' surrounds parental decisions about childhood flu vaccine

(Reuters Health) - Although the annual flu vaccine is recommended for all children older than 6 months, about a third of parents say their child won’t receive one this year, according to a new U.S. poll.

Parents seem to make decisions in an “echo chamber” of information that reinforces their beliefs about flu vaccines, the co-directors of the National Poll on Children’s Health write in the report on their latest survey.

“It’s important to recognize that the universal vaccine offers protection not just for the individual but for the spread of disease in the community, especially among the more vulnerable such as young kids, older adults, and those with autoimmune issues,” said Sarah Clark of the University of Michigan Child Health Evaluation and Research Center in Ann Arbor. Clark co-directs the C.S. Mott Children’s Hospital poll.

In 2010, the Centers for Disease Control and Prevention (CDC) launched a universal influenza immunization recommendation for everyone over age 6 months. However, more than 180 children in the U.S. died from influenza complications last year. And last flu season, less than 60 percent of U.S. kids received a flu vaccine, the poll report notes.

“We’re seeing that parents of older kids or teens who didn’t grow up with the recommendation of getting a flu vaccine every year don’t recognize it as an annual habit,” Clark told Reuters Health in a phone interview. “They see the flu vaccine as something for old people.”

In October, Clark and colleagues surveyed a nationally representative sample of 1,977 parents with at least one child under age 18 about their intentions for getting their children the flu vaccine, as well as their sources of information about the flu vaccine.

About two-thirds of parents said their child would get the flu vaccine this year, and 77 percent said their child’s healthcare provider “strongly” or “mostly” recommended the vaccine. In contrast, 21 percent said they didn’t remember their doctor making a recommendation, and 2 percent said their child’s doctor recommended against the vaccine.

When making decisions about the vaccine, nearly half of parents said they follow the recommendations given by their child’s doctor, and 38 percent said they make decisions based on what they read or hear. Among those who said they followed the doctor’s advice, 87 percent said they would vaccinate their kids this year. Among those who said they make their own decision based on what they read and hear, just 54 percent planned to vaccinate their child.

Compared to parents who didn’t plan to vaccinate, those who said their child would get the vaccine this year also reported four times more information sources that were positive about the childhood flu vaccine, including comments from a doctor, family, friends, other parents, parenting books and magazines, and websites.

In contrast, those who said their child wouldn’t get the vaccine this year reported seven times more sources that were negative about the vaccine and made them question whether to get it for their child. These typically included family, friends, other parents and websites.

“We expected to see more of a balance, but that’s an overwhelming volume of negative sources,” Clark said. “We’re not getting the expert opinion or science communicated, which ends up with parents hearing only one viewpoint and not being able to come to an informed decision.”

Clark and colleagues are continuing to analyze the poll data for more details and plan to distribute updates to doctors around the country, as well as to the CDC. If more pediatricians talk about the importance of the flu vaccine, how it is created, how it works and how it protects a community at large, more parents may feel knowledgeable and comfortable about their child receiving it, she added.

“When I give talks to doctors, I tell them to stop recommending the flu vaccine and start insisting on it,” said Dr. Bill Schaffner of Vanderbilt University Medical Center in Nashville, Tennessee, who wasn’t involved with the poll.

Schaffner and colleagues are seeing more children with complications from the flu arrive at the emergency department in recent years. Even kids who are typically healthy sometimes end up in the intensive care unit within 24 hours of experiencing symptoms, he said.

“When you have diabetes or high blood pressure, doctors don’t say you ought to consider getting treatment, they prescribe the medication,” he told Reuters Health by phone. “This time of year, the same should be true for flu vaccines.”

SOURCE: Mott Poll Report, online November 19, 2018.