Seasonal influenza vaccination for children with special risk medical conditions: Does policy meet practice?

Abstract

Ensuring children with special risk medical conditions (SRMC) are protected from influenza is important. The study objective was to describe influenza vaccination practices of medical professionals caring for children with SRMC and explore characteristics associated with a vaccine recommendation. Design: Cross-sectional survey. Treating paediatric specialists and general practitioners of children with confirmed SRMCs. Postal questionnaire administered from March to September 2018 (option for online response). Characteristics associated with providing a recommendation were explored using univariable and multivariable analyses. Overall response rate of 24.8% with the sample representative of the eligible population in terms of practice location and years practicing medicine. There was a higher response from females and sub-specialists. Of the 198 completed survey responders, 97.8% were aware of the recommendation, yet only 38.4% reported they 'always' routinely recommended influenza vaccine and fewer (19.5%) were very confident in understanding all 'medically at risk' conditions. Medical professionals were more likely to provide a recommendation always or mostly, if they received annual influenza vaccination themselves (adjusted odds ratio (aOR) 3.96, confidence interval (CI) 1.12-14.03), had confidence in understanding all 'medically at risk' conditions (aOR 1.82, CI 1.04-3.17) and perceived ownership of the responsibility to provide the recommendation (aOR 7.35, CI 1.67-32.26). Regional practising medical professionals were less likely to provide a recommendation (aOR 0.25 CI 0.10-0.70). We need to improve medical professionals' knowledge through reminders and access to consistent and concise information about what constitutes a SRMC. Increasing medical professionals' engagement in the influenza vaccination programme could also provide a sense of responsibility fostering provider endorsement.