Psychosocial Influences on Parental Decision-Making Regarding Vaccination Against Seasonal Influenza for Young Children in Hong Kong: a Longitudinal Study, 2012–2013

Purpose: Vaccination uptake remained low, although annual subsidies are provided to encourage 6–72-month-old Hong Kong children to be vaccinated against seasonal influenza. This study was aimed to investigate the psychosocial influences on parental decision-making regarding young children’s seasonal influenza vaccination. Methods: One-thousand two-hundred twenty-six parents of eligible children were recruited using random digit dialing in August–October 2012 to assess baseline perceptions and re-contacted in March 2013 to record children’s vaccination uptake. Structural equation modeling (SEM) was performed to examine factors associated with parental decision about children’s vaccination based on the complete data of 1222 respondents. Results: Of the 1226 respondents who completed the follow-up survey, 34.3 % reported that their child was vaccinated during the follow-up period. Child’s past influenza vaccination history (β = 0.48), belief in vaccination safety (β = 0.35), and social norms (β = 0.25) were strongly associated with parental intention to vaccinate their child which directly predicted child vaccination uptake (β = 0.57). Belief in vaccination safety (β = 0.42) and social norms (β = 0.36) were strongly associated with vaccination intention of parents whose children never received influenza vaccine. Conclusion: Interventions that address concerns on vaccination safety and utilize social norms may be effective to initiate Chinese parents to vaccinate their children.