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Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

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1. Parents who received an influenza vaccine were more likely to immunize their children against both influenza and noninfluenza infections.

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2. When previously nonimmunized parents changed their immunization status, their previously nonimmunized children also had much higher rates of receiving the influenza vaccine in the next season.

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Evidence Rating: 2 (Good)

Study Rundown:

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Previous surveys have demonstrated that parental vaccines attitudes are predictive of children’s immunization status, however no studies have used population-based data to analyze the link between parental and child immunization rates. This study looked at immunization data for caregiver-child pairs in Oregon to determine if child immunization status can be predicted by parental receipt of immunizations. The study also aimed to assess how changes in immunization behavior of parents potentially correlate with changes in their children’s immunization status. Results showed that parents who received vaccines were much more likely to vaccinate their children. This study also demonstrated that previously nonimmunized children of parents who changed their behavior from nonimmunized to immunized had significantly higher rates of subsequently receiving the influenza vaccine. One limitation of this study is that it assumes the adult who accompanied the child at the immunization visit had the greatest influence on decisions about the child’s vaccination status, and it failed to account for children who have more than a single parent responsible for immunization decisions. Findings from this study suggest that targeting parental immunization rates may greatly influence childhood vaccination.

In-depth [retrospective cohort]:

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Using the Oregon ALERT Immunization Information System, researchers analyzed data from 450 687 caregiver-child pairs, based on children aged 9 months to 17 years of age as of January 1, 2015. Children’s immunization records for all recommended vaccines were collected from birth through June 30, 2015. For adults, influenza immunization records were collected covering the 2010-2011 and 2014-2015 influenza seasons (August – May). Pairs were matched based on adult caregivers who accompanied the child to the immunization visit. Results showed that children of caregivers who received influenza immunizations were 2.77 times more likely to receive an influenza immunization (95%CI 2.74-2.79). Results were similar throughout all influenza seasons. When previous season unimmunized caregivers received an influenza vaccine, their children were 5.44 times more likely to become immunized (95%CI 5.35-5.53). Furthermore, when immunized adults declined next season influenza vaccines, their children were 1.78 times more likely to also change to nonimmunized (95%CI 1.76-1.81). These significant degree of concordance between parent and child immunization behavior was seen across all influenza seasons, among children of all ages. The study also showed a small concordance between adult receipt of influenza in the 2014-2015 season and child immunization. For example, with immunizing adult caregivers, children age 9 months to 3 years were 2.97 times (95%CI 2.65-3.34) more likely to have ≥3 DTaP, and adolescents age 11 to 17 years were 2.06 times (95%CI 2.03–2.10) more likely to have completed HPV vaccine series.

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