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OHSU researchers confirm association between parent, child vaccination status

As public health officials urge vaccinations ahead of severe flu season, findings suggest strategy to increase childhood vaccination could be to first target parent vaccination
Zachary Lee, 13 months, of Portland, receives a COVID-19 vaccine as dad, Denny Lie, and mom, Tzu-Hsueh Huang, comfort him on June 25, 2022, at OHSU Doernbecher Children’s Hospital. An OHSU study shows children with a parent that received a flu vaccine were nearly twice as likely to be fully vaccinated by age 2. (OHSU/Christine Torres Hicks)
Zachary Lee, 13 months, of Portland, receives a COVID-19 vaccine as dad, Denny Lie, and mom, Tzu-Hsueh Huang, comfort him on June 25, 2022, at OHSU Doernbecher Children’s Hospital. An OHSU study shows children with a parent that received a flu vaccine were nearly twice as likely to be fully vaccinated by age 2. (OHSU/Christine Torres Hicks)

A new study published in Vaccine found that children with a parent that received a flu vaccine were nearly twice as likely to be fully vaccinated by age 2, compared with children whose parent that did not receive a flu vaccine. The likelihood was even higher for children with two parents who both received a flu vaccine.

The findings from Oregon Health & Science University come as public health officials urge children and adults to get their flu vaccine and COVID-19 boosters ahead of what is expected to be a severe season for flu; already health systems are seeing an increase in respiratory illnesses.

Overall, vaccination rates for children in the United States are high, greater than 90%. However, there are still significant barriers in receiving vaccines: Existing data show that children with Medicaid coverage or who are uninsured and those living in poverty have lower vaccination rates than those who are privately insured and children not living in poverty. This new research aimed to identify any additional factors associated with receiving vaccines that could help increase rates of vaccination. If researchers better understand how parental beliefs and decisions affect childhood vaccinations, it could inform more effective health interventions.

Heather Angier, M.P.H. at OHSU
Heather Angier, M.P.H. (OHSU)

“We know that there are certain factors that hinder children from receiving routine vaccinations, which puts them at risk of serious illness or even death from diseases, many of which are entirely preventable,” said Heather Angier, Ph.D., M.P.H., affiliate assistant professor of family medicine in the OHSU School of Medicine. “This research is important because having a deeper understanding of factors that affect this issue, including parents’ beliefs about vaccines and their vaccination status, is key to increasing vaccination rates among children.”

Previous attempts to improve child vaccination rates included addressing sociodemographic barriers, such as insurance coverage; combatting misinformation; improving communication between clinicians and patients; and addressing vaccine hesitancy with parents. While all of these strategies are important and effective, Angier says results in her new study suggest another strategy to increase child vaccination rates: Increasing efforts to vaccinate parents themselves.  

Researchers used electronic health record data to identify children and linked parents who had been seen in community health centers across 16 states. Under a retrospective, cohort study design, researchers were able to use logistic regression to estimate the odds of a child being up-to-date on vaccinations based on their linked parents’ flu vaccination status.

This research is especially important as hesitancy around COVID-19 vaccines has affected vaccination rates for children younger than 2, resulting in a decline of about 22% during the pandemic. Looking ahead, Angier says more research is needed to understand how COVID-19 vaccine hesitancy has impacted compliance for other childhood vaccinations, and which strategies might be used to return childhood vaccinations back to pre-pandemic levels.

Additionally, clinicians warn of especially severe rates of viral illness this fall and winter. As COVID-19 swept the globe, there were significantly lower rates of other viruses circulating, including flu and respiratory syncytial virus, known as RSV. However, the lack of exposure to these illnesses over the past two years also means that child and adult immune systems lack practice in fighting off these viruses, so getting vaccinated is especially important this year.

Flu vaccines, COVID-19 vaccines and booster shots are widely available for both children and adults at pharmacies and health care facilities across Oregon. Click here to search for where to get vaccinated.

"Association of parent influenza vaccination and early childhood vaccinations using linked electronic health record data" by Jorge KaufmannJennifer E. DeVoeHeatherAngierLaura MorenoViviane CahenMiguelMarino(https://doi.org/10.1016/j.vaccine.2022.09.040). It appears in Vaccine, Volume 40, Issue 47 (November 2022), published by Elsevier. 

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