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In May 2004, the Advisory Committee on Immunization Practices recommended universal influenza vaccination for children aged 6 to 23 months.1 However, as shown by Humiston et al2 in a recent issue of the ARCHIVES and Daley et al,3 costs, lack of immunization clinics, and limits of recall systems are barriers to widespread vaccination, even for children with medical conditions that require influenza vaccination.
In Italy, vaccinations are administered in public vaccination centers. However, despite specific facilities, immunization rates for influenza are less than 5% of the overall pediatric population and less than 10% for children with specific risk factors for whom vaccination is highly recommended.4
At the beginning of the 2003 influenza season, experts from authoritative medical organizations and scientific societies, interviewed by the mass media as to the need to vaccinate children, gave inconsistent and conflicting opinions on the opportunity of extending vaccination to healthy children. On the other hand, the issue of children at risk was largely ignored. The same happened as the 2004 influenza season approached.
We performed a survey to evaluate the main source of information about vaccinating children against influenza. We tested the hypothesis that mass media is a more effective vehicle for disseminating information about vaccinating children than are medical associations or pediatricians.
In November 2003, a structured oral questionnaire was administered to parents of children aged 6 to 23 months accessing 3 vaccination centers in Campania (southern Italy) for mandatory (not including influenza vaccination) or influenza vaccinations.
A total of 283 parents were interviewed; 163 parents brought their children for mandatory vaccination and 120, for influenza vaccination because of specific risk factors. In the mandatory group, awareness of influenza vaccination was as high as 90% (149/163). Consequently, overall awareness of influenza vaccination reached 95% (269 of 283 interviewed parents). Sixty-two percent (167/269) learned of influenza vaccination through the mass media and 38% (102/269), through their pediatricians. The percentage of parents who received information through the mass media was surprisingly similar in the 2 groups: 91 (61%) of 149 in the mandatory group and 76 (63%) of 120 in the influenza vaccination group.
This finding suggests that the vast majority of parents who bring their children to vaccination centers for influenza immunization in the presence of specific medical risk factors do so because of mass media rather than medical communication. Of the 61% of parents in the mandatory group who were aware of influenza vaccination, almost all (88 [97%] of 91) reported their intention to do so, provided that their pediatricians supported this indication.
A major issue in childhood influenza vaccination programs is the difficulty in identifying and recalling children with chronic medical conditions.3 Our survey shows that, where vaccination centers are available, the mass media is an effective channel for information for specific groups and for the general population. Given the high social impact of influenza in children and the need to immunize a large number of subjects in a limited time frame, the delivery of unequivocal messages through the mass media is an obvious answer.
Correspondence: Dr Guarino, Department of Pediatrics, University “Federico II,” Via S Pansini 5, 80131 Naples, Italy (alfguari@unina.it).
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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