November 20, 2018
3 min read

One-third of parents are declining flu vaccination for their child this year

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Sarah J. Clark, MPH
Sarah J. Clark

A C.S. Mott Children’s Hospital National Poll on Children’s Health demonstrated that a significant number of parents choose not to vaccinate their child against influenza. The survey showed that nearly 40% made they made their decision based on what they read or heard about the vaccine. Researchers said this is a result of an “echo chamber” effect related to negative information.

Additionally, one in five parents reported that their child’s provider did not recommend the influenza vaccine this year.

“It is important to recognize that there are a fair number of parents out there who believe their doctors are not giving a strong recommendation,” Sarah J. Clark, MPH, associate research scientist at the University of Michigan Medical School and co-director of the C.S. Mott Children’s Hospital National Poll on Children’s Health, told Infectious Diseases in Children. “It is good to answer questions and talk about the nuance of the influenza vaccine not being 100% effective in preventing all cases, but pediatricians need to stress that it works well in reducing the severity of disease.”

The poll included 1,977 parents aged 18 years and older who were randomly selected and had at least one child. About half (51%) reported that their child’s provider strongly recommended vaccination, whereas 26% said the provider did not give a straightforward recommendation. Nearly 25% of parents did not recall their provider making a recommendation, and 2% reported that their provider suggested their child remain unvaccinated against influenza.

Graph comparing parents who intend to vaccinate their child against influenza and those who intend not to 
Four in 10 parents said they based their decisions about the influenza vaccine on what they read and heard. Those who use this as their primary source of information were less likely to have their child vaccinated when compared with parents who follow their health care provider's recommendation. Click to enlarge
Source: C.S. Mott Children’s Hospital National Poll on Children’s Health at the University of Michigan

Slightly less than half of parents (48%) said they followed their health care provider’s recommendations. Among parents who usually follow the recommendation of their child’s health care provider, 87% said they were likely to get their child vaccinated this year.

According to the researchers, 38% of patients based their decisions on what they heard or read. Only slightly more than half (56%) of these parents reported that they would be getting their child vaccinated this year.

Clark and colleagues said that parents who chose not to vaccinate their child had seven times more negative information sources about the vaccine. The most influential negative information included comments from family or close friends (45%) or other parents (44%). The internet was also frequently cited as a source of negative information (40%), in addition to comments from their child’s provider (35%), nurses or medical staff (32%), or books and magazines (32%).


In contrast, parents who intended on vaccinating their child had four times the number of positive sources, the most common of which included comments from their child’s provider (67%), nurses and medical staff (59%), comments from family or close friends (47%), other parents (42%), and parenting books and magazines (34%). Approximately 33% of parents reported seeing suggestions for influenza vaccination on the internet.

“What we found was that there is a difference in the information sources for parents who either got the influenza vaccine for their child or were planning on getting one,” Clark said.  “Those people most often cited their child’s health care provider or clinic nurses or medical staff as their information sources. Health care providers were more likely to give information that made parents want to get their child vaccinated.”

Clark stressed that pediatricians should ask about influenza vaccination year-round, not just during influenza season.

“For kids who do not see their provider during influenza season, which can be a lot of kids, providers may fail to even address the influenza season,” she said. “They need to ask about vaccination year-round. Providers should also be willing to take the time to have the conversation about the vaccine when they hear hesitancy or refusal from a parent. There are still some doctors who do not want to get into that conversation for many reasons, but when they see that imbalance of information sources, that is when the doctor is needed to inform them of the other side.” – by Katherine Bortz


CDC: Influenza (Flu). Accessed November 20, 2018.

Clark SJ, et al. CS Mott Children’s Hospital National Poll on Child Health. 2018;33(1).

Disclosure: Clark reports no relevant financial disclosures.