Influenza vaccination among two year olds in a population-based survey

Background: Children aged 6 months through 18 years old should receive influenza vaccination every year because high levels of immunity among children can decrease influenza morbidity and mortality among the elderly. Using a population-based sample, we explored the proportion of two year olds who had received influenza vaccination.

Methods: Oregon PRAMS is a stratified random sample of women who have recently had a live birth. PRAMS-2 reinterviews PRAMS respondents shortly after the child's second birthday. This work follows children born in 2004 and 2005 whose mothers were reinterviewed shortly after the child's second birthday.

Results: 37.5% of two year olds had received an influenza vaccination in the past year. Influenza vaccination was seasonal: reports of influenza vaccination ranged from 11.0% - 58.8%, depending on the child's month of birth. The two year olds born in November had the highest reported rate of influenza vaccination; those born in August had the lowest rate.

Conclusions: The children most likely to have received an influenza vaccination were probably in their provider's office for a routine two year old well child care visit at a time when the provider had influenza vaccine available. Further improvement in vaccinating children will probably require office systems to vaccinate children who would not normally be in providers' offices at the time when the vaccine is available in provider offices. In the long run, there is a need to explore and develop three strategies for providing influenza vaccine to all children: provider-based strategies, school-based strategies and community-based strategies.