Determinants of parental self-reported uptake of influenza vaccination in preschool children during the COVID-19 pandemic

ABSTRACT

In China, the coverage rate of influenza vaccination among the general population is significantly lower than that of high-income countries, with only 2.46% of the population vaccinated. Preschool-aged children are particularly susceptible to influenza viruses, yet the factors that influence parents’ willingness to vaccinate their children are not well understood. To address this research gap, we developed a theoretical model grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT), which explores six key factors influencing parental self-reported uptake of influenza vaccination in preschool children: performance expectancy, effort expectancy, social influence, facilitating conditions, knowledge, and behavioral intention. We collected data from 872 parents of children in five major cities in China and employed structural equation modeling to examine the significance of the theoretical model and explore the potential moderating effects of demographic variables on path relationships. Our analysis revealed that several positive factors influenced parents’ intention of influenza vaccination for preschool children, including effort expectancy (β = 0.38), social influence (β = 0.17), and knowledge (β = 0.52). Facilitating conditions (β = 0.34), knowledge (β = 0.40), and behavioral intention (β = 0.34) were found to be associated with self-reported uptake. Furthermore, we observed significant moderating effects of the child’s gender and age, as well as the guardian’s category and income, on the theoretical models. Parents’ willingness to vaccinate preschool children against influenza is influenced by both psychological and demographic variables. Further studies are needed to determine if these relationships persist over time and across different regions.

KEYWORDS:

• Influenza vaccination
• preschool children
• parental intention
• knowledge
• China

Author contributions

SQ, MZ, and MY were responsible for the study conception and contributed to the elaboration of the questionnaire. MZ, HX, and WH contributed to data collection and conducted the statistical analyses. MZ, SQ, XT, and KC revised the manuscript and submitted it. All authors were implicated in the final manuscript preparation and approved the final manuscript. Each author agrees to be personally accountable for the author’s own contributions. All authors attest that they meet the ICMJE criteria for authorship.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by National Social Science Fund of China [21BGL227], Natural Science Foundation of Hunan Province [2021JJ30201, 2023JJ30839], and Hunan Social Science Evaluation Committee [grant number XSP21YBC313].