Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

Few studies have examined potential factors that contribute to low influenza vaccination rates among minority children. This
study aimed to assess the prevalence of early childhood influenza vaccination among young black and Latino children, living
in inner-city neighborhoods, and examine the effects of child, caregiver and health system factors. Secondary data analysis
was performed using a survey about medical home experiences conducted from May 2007–June 2008. The study sample was limited
to children ≥6 months in any influenza season prior to the 2006–2007 influenza season. Bivariate analyses and multivariable
logistic regression tested associations between influenza vaccination receipt and socio-demographic and health system characteristics.
One-third of children received an influenza vaccination by the end of 2006–2007 season, while only 11% received a vaccination
within their first season of eligibility. Black children were more likely than Latino children to have been vaccinated (50%
vs. 31%, P < 0.01) during their first few eligible seasons. Children whose mothers were older, proficient in English, and frequent users
of healthcare were more likely to obtain vaccination. Child attendance at healthcare settings with immunization reminder systems
was also positively correlated with influenza vaccination. Our findings suggest that initial vaccination receipt among minority
children from inner-city communities might be improved by expanded influenza promotion activities targeting younger mothers
or those with limited English proficiency. Strategies to increase the frequency of child’s actual contact with the medical
home, such as reminder systems, may be useful in improving uptake of influenza vaccination among inner-city, minority children.