SEATTLE — In one-third of children with asthma who are not vaccinated against influenza, the vaccine is withheld because parents believe it has no benefit.
Influenza exacerbates asthma, and annual flu vaccination is recommended for high-risk children, including those with chronic asthma, Dr. Sudha Reddy, a fellow at the Children's Hospital of Michigan in Detroit, and her colleagues reported at the annual meeting of the American College of Allergy, Asthma, and Immunology.
To determine the prevalence of flu vaccination in children with asthma and reasons for receipt and nonreceipt of the vaccine, they conducted a clinic-based study of 93 children and their parents in the fall of 2004. “During that year, there was a nationwide shortage of flu vaccine due to manufacturing problems,” Dr. Reddy noted in an interview. She and her colleagues hypothesized that vaccination rates would be high given media coverage of the shortage and the resulting increased public awareness.
The children were aged 5-18 years, had established asthma, and were visiting an allergy clinic in a university-affiliated hospital. They and their parents completed questionnaires asking about demographics, the severity of their asthma, their influenza vaccination status, and reasons for vaccinating or not vaccinating. Asthma was rated as mild in 55% and as moderate or severe in 45%.
Of the total, 67% of the children received the flu vaccine. The leading reason parents gave for vaccinating was that a physician recommended it (44%). Other reasons were: routinely getting the vaccine (21%), hearing about it through school (15%), being aware of the vaccine (12%), and news of the vaccine shortage (8%).
The leading reason for not vaccinating children was lack of benefit of the vaccine (32%). Other reasons were: a previous experience of vaccine-related adverse events (22%), a perception that the children would not get the flu (16%), a preference that the children would become ill rather than receive the vaccine (10%), an allergy to eggs (6%), a preference to not vaccinate (6%), and failure of the physician to recommend it (3%). In all, 5% of parents didn't answer this question.
In terms of perceived benefits of the vaccine, 48% of parents believed it prevented influenza illness, and 47% believed it helped control asthma. The most common adverse events were local pain (44%) and fever (13%). Only 2% experienced a worsening of their asthma.
Most of the parents (61%) said their physician was their source of information about flu vaccination. Other sources included the media generally (23%), news regarding the vaccine shortage specifically (13%), and family members (3%).
“Influenza immunization is inadequate even in a high-risk group like [children with] asthma,” Dr. Reddy said, adding that more research is needed to determine if findings are similar in larger samples and other settings. The researchers concluded that physicians are the best source of information on the flu vaccine for most patients and should discuss vaccination with patients at every opportunity.
Dr. Reddy reported that she had no conflicts of interest.
Physicians are the best source of information on the flu vaccine and should discuss it with patients at every opportunity. DR. REDDY