Parental attitudes affecting compliance with the recommendation for two doses of 2009 pandemic influenza A (H1N1) vaccine in children less than 10 years of age in West Virginia.

OBJECTIVE: It is unclear why parents would decline the second dose of an influenza vaccine for their children during a declared global pandemic. Therefore our objective was to examine parental attitudes behind parents foregoing the second dose of 2009 pandemic influenza A (H1N1) vaccine for their children in Kanawha County, WV. METHOD: A survey tool addressing barriers to receiving second dose was developed and validated with a randomly generated parent focus group. The West Virginia's Statewide Immunization Information System (WVSIIS) database listed 1,925 parents who have one child or more who received the first but not the second dose of vaccine within the recommended time period. The surveys and letters were sent to all the 1,925 parents. Participants were offered the choice of completing a paper version of the survey sent through the mail or an online version at a password-protected website. RESULTS: A total of 381 surveys were received (345 hardcopy surveys and 36 online surveys) and were included in the analyses (response rate 22.0%). Of these 381 respondents 249 did not meet the inclusion criteria. Thus our effective response rate was 132/1525, or 8.66%. The major reasons for respondents being unable to have their child(ren) receive the second dose were related to access limitations. A perception of low urgency and safety of vaccine were other concerns. However, the majority of respondents (80%) did not cite safety concern as a reason for not accepting the second dose. CONCLUSION: Our findings suggest that rather than safety concerns, parents often faced access challenges in having their children fully vaccinated which were perhaps not widely recognized.