Influenza Vaccination among Young Children: A Case for Improvement

By: Hannah Stuart
Monday, August 1, 2016

Full influenza vaccination coverage of infants and toddlers in the United States remains alarmingly low, according to recent estimates.

Despite an increase of nearly 40 percent in full vaccination from the 2002–2003 influenza season to the 2011–2012 season, a study by researchers at the CDC found the rate at the end of that period was still only 44.7 percent. Researchers reviewed data from the National Immunization Survey, a telephone survey of homes with young children.

“After the telephone interview, they ask the parents to name all the vaccination providers,” says Tammy Santibanez, PhD, epidemiologist at the CDC and one of the researchers. “The study did show there was an increase from when influenza vaccination was first recommended for all children 6–23 months, ... but 10 years in, by the ’11-’12 season, only 45 percent of these children 6–23 months were fully vaccinated.”

Throughout all 10 seasons examined, rates of full vaccination were lower among non-Hispanic black children and Hispanic children than among non-Hispanic white children, with non-Hispanic black children at 35 percent, Hispanic children at 40 percent and non-Hispanic white children at 49 percent.

Across the board, one key reason for low vaccination rates is parents who are not aware that one dose of influenza vaccine is insufficient.

“Many parents may not realize that a child needs two doses in the first year they’re vaccinated,” says Richard K. Zimmerman, MD, MPH, Professor of Family Medicine at the University of Pittsburgh. “What we’ve learned from flu vaccination is that the immune system needs experience with flu virus before it responds well.”

Emphasis on Education

Santibanez stresses that educating parents on the importance of vaccination is one of the most effective ways of increasing the influenza vaccination rate. She also encourages providers to refresh themselves on the guidelines annually as to whether a child requires one or two doses, as these guidelines can change with each flu season.

Dr. Zimmerman says scheduling an appointment for the second dose of flu vaccine before parents leave the office after their first appointment is a good idea as well.

“That’s probably the best, and then [sending parents] reminders,” he says. “Have that scheduled [second] visit be convenient as an in-and-out, nurse-based vaccination.”