The Rate of Seasonal Influenza Vaccination in Diabetic Children, the Effect of Recommendation and the Factors Influencing the Acceptance of Recommendation: An Interventional Study

Öz

Objective: To investigate the vaccination rate of influenza in diabetic children and the effect of recommendation and other factors on vaccination rate. Material and Methods: On July 2011, 144 diabetic children and their families were informed about and were recommended to receive the influenza vaccine every year, in September. On December 2011, parents were questioned about the vaccination. Results: Influenza vaccination rate of the previous season (28.3%) increased to 50.0% (p<0.05). Receiving the vaccine in 2010 was the only contributing factor to the recommendation success. The reasons given by the non-receivers were; forgetting (50.0%), fear of adverse-effects (26.4%), not believing in usefulness (15.2%), rejection by the child (4.2%) and effects of media (4.2%). 88.9% of those who forgot declared that they would receive if they were reminded at the beginning of the season. Conclusion: The rate of influenza vaccination was low. The majority of those who didn't recieve the vaccination declared that they would if they were reminded at the beginning of the season and the fact that “receiving the vaccine in 2010” was the only factor influencing the recommendation success indicate that recommending isn't enough but that reminding and giving detailed information about the vaccine will increase vaccination rates independent of other factors. Turkish Amaç: Diyabetik çocuklarda grip aşısı yaptırma oranı ile aşılanma oranı üzerine tavsiyelerin ve diğer faktörlerin etkisini araştırmak Hastalar ve Metod: Temmuz 2011´de 144 diyabetik çocuk ve ailesi her yıl eylül ayında grip aşısı yaptırmaları konusunda bilgilendirildi ve bu yönde tavsiyelerde bulunuldu. Aralık 2011´de ailelerle aşıyı yaptırıp yaptırmadıkları konusunda tekrar görüşüldü. Sonuçlar: Grip aşısı yaptırma oranları bir önceki döneme göre artmıştır (% 28,3 ten % 50 ye p<0.05). Tavsiyelerin başarısı üzerine katkısı olan tek faktör 2010 yılında aşı yaptırmaktı. Yaptırmama sebepleri sırasıyla unutma (50.0%), yan etkilerinden korkma (26.4%), faydasının olmadığını düşünme (15.2%), çocuğun istememesi (4.2%) ve medyanın etkisi (4.2%) idi. Aşıyı yaptırmayı unutanların % 88.9´u eğer mevsimin başında hatırlatılsaydı aşıyı yaptırırdık dediler. Karar: Grip aşısı yaptırma oranları düşüktür. Aşıyı yaptırmayanların büyük bir bölümü eğer mevsimin başında hatırlatılsaydı aşıyı yaptırırdık demesi ve tavsiyelerin başarısı üzerine katkısı olan tek faktörün “2010 yılında aşı yaptırmak” olması sadece tavsiye etmenin yeterli olmayacağını ; hatırlatma yapmanın ve aşı hakkında detaylı bilgi vermenin aşı yaptırma oranlarını diğer faktörlerden bağımsız bir şekilde arttıracağını düşünüyoruz.

Anahtar Kelimeler

• Influenza, influenza vaccine, diabetes, vaccination

The Rate of Seasonal Influenza Vaccination in Diabetic Children, the Effect of Recommendation and the Factors Influencing the Acceptance of Recommendation: An Interventional Study

Öz

Kaynakça

1. Smith SA, Poland GA. Use of influenza and pneumococcal vac- cines in people with diabetes. Diabetes Care 2000;23:95-108. [CrossRef]
2. Tan EK, Lim LH, Teoh YL, Ong G, Bock HL. Influenza and seasonal influenza vaccination among diabetics in Singapore: knowledge, attitudes and practices. Singapore Med J 2010;51:623-30.
3. Joshi N, Caputo GM, Weitekamp MR, Karchmer AW. Infections in patients with diabetes mellitus. N Engl J Med 1999;341:1906-12. [CrossRef]
4. American Academy of Pediatrics. Immunization in special clinical circumstances. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2009 Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: AAP, 2009: 68-104.
5. Smith SA, Poland GA; American Diabetes Association. Immuniza- tion and the prevention of influenza and pneumococcal disease in people with diabetes. Diabetes Care 2003;26:126-8. [CrossRef]
6. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention. MMWR Recomm Rep 1998; 47(RR-6): 1-26.
7. American Diabetes Association. Standards of medical care for pa- tients with diabetes mellitus. Diabetes Care 2003;Suppl 1:33-50.
8. U:S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washing- ton, DC, U.S. Government Printing Office, 2000.

9. Giannattasio A, Squeglia V, Lo Vecchio A, Russo MT, Barbarino A, Carlomagno R, et al. Pneumococcal and influenza vaccination rates and their determinants in children with chronic medical con- ditions. Ital J Pediatr 2010;36:28. [CrossRef]
10. Szilagyi PG, Rodewald LE, Savageau J, Yoos L, Doane C. Improv- ing influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predict- ing vaccination compliance. Pediatrics 1992;90:871-5.
11. Pandolfi E, Carloni E, Marino MG, Ciofi Degli Atti ML, Gesual- do F, Romano M, et al. Immunization coverage and timeliness of vaccination in Italian children with chronic diseases. Vaccine 2012;30:5172-8. [CrossRef]
12. Tillmann BU, Tillmann HC, Heininger U, Lütschg J, Weber P. Ac- ceptance and timeliness of standard vaccination in children with chronic neurological deficits in north-western Switzerland. Eur J Pediatr 2005;164:320-5. [CrossRef]
13. Daley MF, Beaty BL, Barrow J, Pearson K, Crane LA, Berman S, et al. Missed opportunities for influenza vaccination in children with chronic medical conditions. Arch Pediatr Adolesc Med 2005;159:986-91. [CrossRef]
14. López-de-Andrés A, Carrasco-Garrido P, Hernández-Barrera V, de Miguel AG, Jiménez-García R. Coverages and factors associated with influenza vaccination among subjects with chronic respiratory diseases in Spain. Eur J Public Health 2008;18:173-7. [CrossRef]
15. Rosenbloom AL, Silverstein JH: Diabetes in the child and ado- lescent In: Lifshitz F (ed) Pediatric Endocrinology. Marcel Dekker, 4th. ed, New York, 2003:611-52.
16. Esposito S, Tremolati E, Bellasio M, Chiarelli G, Marchisio P, Tiso B, et al. V.I.P. Study Group. Attitudes and knowledge regarding influenza vaccination among hospital health workers caring for women and children. Vaccine 2007;25:5283-9. [CrossRef]
17. Rodríguez-Rieiro C, Domínguez-Berjón MF, Esteban-Vasallo MD, Sánchez-Perruca L, Astray-Mochales J, Fornies DI, et al. Vaccina- tion coverage against 2009 seasonal influenza in chronically ill children and adults: analysis of population registries in primary care in Madrid (Spain). Vaccine 2010;28:6203-9. [CrossRef]
18. Karthikeyan A, Agwu JC. Uptake of influenza vaccination among children with diabetes- a re-audit. J Infect 2008;56:158-9. [CrossRef]
19. Lin CJ, Nowalk MP, Zimmerman RK, Ko FS, Zoffel L, Hoberman A, et al. Beliefs and attitudes about influenza immunization among parents of children with chronic medical conditions over a two- year period. J Urban Health 2006;83:874-83. [CrossRef]
20. Lin CJ, Zimmerman RK, Nowalk MP, Ko FS, Raymund M, Hober- man A, et al. Parental perspectives on influenza vaccination of children with chronic medical conditions. J Natl Med Assoc 2006;98:148-53.
21. Esposito S, Marchisio P, Droghetti R, Lambertini L, Faelli N, Bosis S, et al. Influenza vaccination coverage among children with high- risk medical conditions. Vaccine 2006;24:5251-5. [CrossRef]
22. Egede LE. Association between number of physician visits and influenza vaccination coverage among diabetic adults with ac- cess to care. Diabetes Care 2003;26:2562-7. [CrossRef]
23. Cooper Robbins SC, Leask J, Booy R. Parents’ attitudes towards the influenza vaccine and influencing factors. J Paediatr Child Health 2011;47:419-22. [CrossRef]
24. Gaglani M, Riggs M, Kamenicky C, Glezen WP. A computerized reminder strategy is effective for annual influenza immunization of children with asthma or reactive airway disease. Pediatr Infect Dis J 2001;20:1155-60. [CrossRef]
25. Fitch P, Racine A. Parental beliefs about vaccination among an ethnically diverse inner-city population. J Natl Med Assoc 2004;96:1047-50.
26. Keane MT, Walter MV, Patel BI, Moorthy S, Stevens RB, Bradley KM, et al. Confidence in vaccination: a parent model. Vaccine 2005;23:2486-93. [CrossRef]
27. Kimmel SR, Burns IT, Wolfe RM, Zimmerman RK. Addressing im- munization barriers, benefits, and risks. J Fam Pract 2007;56:61-9.
28. Hak E, Schönbeck Y, De Melker H, Van Essen GA, Sanders EA. Negative attitude of highly educated parents and health care workers towards future vaccinations in the Dutch childhood vac- cination program. Vaccine 2005;23:3103-7. [CrossRef]
29. Wahid ST, Nag S, Bilous RW, Marshall SM, Robinson AC. Audit of influenza and pneumococcal vaccination uptake in diabetic pa- tients attending secondary care in the Northern Region. Diabet Med 2001;18:599-603. [CrossRef]
30. Kroneman M, van Essen GA, John Paget W. Influenza vaccination coverage and reasons to refrain among high-risk persons in four European countries. Vaccine 2006;24:622-8. [CrossRef]
31. Daley MF, Crane LA, Chandramouli V, Beaty BL, Barrow J, Allred N, et al. Misperceptions about influenza vaccination among par- ents of healthy young children. Clin Pediatr (Phila) 2007;46:408-17. [CrossRef]
32. Akis S, Velipasaoglu S, Camurdan AD, Beyazova U, Sahin F. Factors associated with parental acceptance and refusal of pandemic influ- enza A/H1N1 vaccine in Turkey. Eur J Pediatr 2011;170:1165-72. [CrossRef]