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Associations Between Health Care Professional Communication Practices and Influenza Vaccination of Hospitalized Children

  • Annika M. Hofstetter
    Correspondence
    Address correspondence to Annika M. Hofstetter, MD, PhD, MPH, Seattle Children's Research Institute, M/S CURE-4, PO Box 5371, Seattle, WA 98145-5005
    Affiliations
    Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash

    Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
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  • Douglas J. Opel
    Affiliations
    Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash

    Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
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  • Melissa S. Stockwell
    Affiliations
    Department of Pediatrics, Columbia University (MS Stockwell), New York, NY

    Department of Population and Family Health, Mailman School of Public Health, Columbia University (MS Stockwell), New York, NY
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  • Clarissa Hsu
    Affiliations
    Kaiser Permanente Washington Health Research Institute (C Hsu and RM Mangione-Smith), Seattle, Wash
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  • Chuan Zhou
    Affiliations
    Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash

    Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
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  • Rita M. Mangione-Smith
    Affiliations
    Kaiser Permanente Washington Health Research Institute (C Hsu and RM Mangione-Smith), Seattle, Wash
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  • Janet A. Englund
    Affiliations
    Department of Pediatrics, University of Washington School of Medicine (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash

    Seattle Children's Research Institute (AM Hofstetter, DJ Opel, C Zhou, and JA Englund), Seattle, Wash
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      Abstract

      Background

      Health care professionals (HCPs) (eg, nurses, doctors) play a key role in vaccine uptake. Few studies describe HCP influenza vaccine communication with parents of hospitalized children.

      Methods

      This study included English- and Spanish-speaking parents of influenza vaccine-eligible children hospitalized at a tertiary care pediatric hospital between October 2018 and May 2019. A survey was completed online or via telephone 2 to 15 weeks (median 4 weeks) after discharge. It examined parental intent to vaccinate their child during hospitalization and parent-reported inpatient HCP communication practices (eg, vaccine recommendation strength, format for initiating the recommendation). Multivariable logistic regression examined the associations between HCP communication practices and influenza vaccination during hospitalization, adjusting for demographic, clinical, and visit characteristics.

      Results

      Parents (n = 194; 63.0% response rate) were mostly white (66.8%) and English-speaking (97.4%). Their children were primarily 5 through 17 years (67.0%) with chronic disease (68.6%); 24.7% were vaccinated before discharge. Most parents initially had no plan (55.6%) or planned to decline (31.1%) influenza vaccine for their child during hospitalization. Of these parents, 22.2% decided to accept the vaccine, 66.7% citing a HCP conversation as the main reason for changing their mind. Overall, 75.3% recalled a HCP conversation about influenza vaccination. Of these parents, 61.0% reported a HCP recommendation (53.8% described it as “very strong”; 11.1% noted a presumptive initiation format). A parent-reported HCP conversation (adjusted odds ratio [AOR] 5.23, 95% confidence interval [CI] 1.64–16.68) and recommendation (AOR 5.59, 95% CI 2.01–15.51) were associated with influenza vaccination during hospitalization.

      Conclusion

      This study highlights the importance of discussing and recommending influenza vaccination with parents of hospitalized children.

      Keywords

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