Association between parental and child influenza vaccination: A national health survey analysis

Abstract

Background: Influenza vaccination effectively prevents influenza-related illness and hospitalization. However, vaccination rates among Korean children and adolescents remain suboptimal. Given the strong influence of parents on their children's vaccination decisions, this study investigated the relationship between parental influenza vaccination status and their children's vaccine uptake. Methods: We analyzed 10,674 child-parent pairs from the Korea National Health and Nutrition Examination Survey collected in 2010-2012 and 2014-2022. Parental and children's vaccination statuses within the past year were surveyed using a self-reported question. Parental vaccination status was grouped into four categories: none, father-only-, mother-only-, and both-vaccinated group. Children's influenza vaccination rates by age were analyzed using survey weighted proportions. Survey weighted multiple logistic regression was used to evaluate the association between parental and children's influenza vaccination statuses. Results: Vaccination rates were consistently higher in children with both parents vaccinated compared to those with neither parent vaccinated, and this difference was more pronounced at older child ages. Compared to children with unvaccinated parents, those with vaccinated fathers (OR = 1.84; 95 % CI: 1.46-2.33), mothers (OR = 9.39; 95 % CI: 7.68-11.47), or both parents (OR = 19.74; 95 % CI: 15.20-25.63) had significantly higher odds of vaccination. These associations showed a dose-response relationship (P for trend <0.001) and remained consistent across age groups. Conclusion: Parental influenza vaccination status was strongly associated with children's vaccination uptake, with a clear dose-response pattern based on the number of vaccinated parents. These findings suggest that family-based vaccination strategies could effectively improve vaccination rates among children and adolescents.