Birmingham, AL—While some parents refuse to have their children vaccinated against the flu because of usually unfounded fears of possible side effects, the reasons are much more mundane among others, who aren’t sure a shot is really needed or just haven’t gotten around to it.

That’s according to a new report in the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology.

For the study to determine why influenza vaccines are not more widely used, a University of Alabama School of Medicine researcher enrolled 131 of 140 eligible patients—9 months to 18 years old—who were tested for influenza in a single, small suburban pediatric practice during the 2012-13 influenza season. Parents completed a written questionnaire asking about previous history of influenza, vaccination at other facilities, reasons for not vaccinating, and intention to vaccinate next year.

“The first and most common reason could encompass a belief that risk for contracting influenza is low in their family as well as that the vaccine offers little protection,” explained study author Scott Field, MD. “A reason rarely discussed in the medical literature relating to why many parents do not think influenza vaccines are needed is the infrequency with which many individuals and families experience influenza first hand.”

In fact, the study indicated that most influenza-positive patients (59%) and controls (89%) in the study had no prior influenza history, those with previous influenza were likely to be more open to prevention efforts.

Results also indicate that, in this group, influenza vaccines were used less frequently than the hepatitis A vaccine, despite the fact that hepatitis A is a relatively low-risk disease compared to influenza.

Another study, published in the journal Pediatrics, also looked at reasons for underimmunization of children against the flu. Pointing out that complementary and alternative medicine (CAM) is increasingly used in the United States, it notes that some CAM practitioners recommend against vaccinations in general and that children regularly visiting naturopathic physicians or chiropractors were less likely to receive vaccines and more likely to get vaccine-preventable diseases.

Focusing specifically on influenza vaccine, Pennsylvania State University–led researchers analyzed information for about 9,000 children from the Child Complementary and Alternative Medicine File of the 2012 National Health Interview Survey. Results indicate that influenza vaccination uptake was lower among children ever versus never using alternative medical systems (AMS), at a rate of 33% versus 43%, or manipulative and body-based therapies, 35% versus 43%. Flu-vaccine rates were higher, however, among children who were given multivitamins and multiminerals—45% versus 39%.

“Children who have ever used certain CAM domains that may require contact with vaccine-hesitant CAM practitioners are vulnerable to lower annual uptake of influenza vaccination,” study authors point out. “Opportunity exists for U.S. public health, policy, and medical professionals to improve child health by better engaging parents of children using particular domains of CAM and CAM practitioners advising them.”

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