Attitudes and behaviors of adolescents with asthma and their parents toward influenza and COVID-19 vaccination: barriers and facilitators of uptake

Overview

This cross-sectional study examined attitudes, behaviors, and determinants of influenza and COVID-19 vaccination uptake among adolescents with physician-confirmed asthma diagnoses and their parents. Asthma represents a significant chronic disease burden in adolescence and substantially elevates risk for severe complications from respiratory viral infections. Despite vaccination constituting the primary preventive intervention, immunization rates in this population remain suboptimal. The research prioritized identification of barriers and facilitators influencing vaccination acceptance, with emphasis on parental beliefs and vaccine hesitancy as critical mediating factors.

Methods and approach

The study employed a descriptive, cross-sectional design conducted at a Pediatric Allergy and Immunology outpatient clinic from May through September 2022. Participants comprised 212 adolescents aged 12-18 years with documented asthma diagnoses and their parents, recruited consecutively during routine follow-up appointments. Data collection involved face-to-face administration of a structured questionnaire by physicians, addressing demographic characteristics, vaccination history, knowledge, attitudes, and concerns regarding influenza and COVID-19 immunization. Analysis utilized descriptive and comparative statistical methods with significance threshold set at p<0.05.

Key Findings

Among 212 participating adolescents (median age 14 years; 52.8% male), only 23.6% reported prior influenza vaccination with 6.6% demonstrating regular vaccination patterns. Approximately 87.7% of adolescents expressed willingness to receive influenza vaccination and 81.6% expressed willingness toward COVID-19 vaccination. Parental vaccination status emerged as the most robust determinant of adolescent vaccination behavior. Parental influenza vaccination independently predicted adolescent influenza vaccination uptake (odds ratio 7.26, 95% confidence interval 3.29-16.0), and parental COVID-19 vaccination status predicted adolescent willingness to receive COVID-19 vaccination (odds ratio 48.53, 95% confidence interval 12.26-192.18). Discordance was observed between expressed willingness and actual influenza vaccination uptake, contrasting markedly with elevated COVID-19 vaccination rates.

Implications

Parental vaccination status functioned as a dominant predictor of adolescent immunization behavior, suggesting that interventions targeting parental knowledge, attitudes, and vaccine confidence may constitute a primary mechanism for improving adolescent vaccination coverage. The substantial gap between stated willingness for influenza vaccination and actual uptake indicates that expressed attitudes insufficiently predict behavioral outcomes, necessitating investigation of intervening variables between intention and action in this population. Safety concerns, particularly regarding long-term vaccine effects, represented a critical barrier to uptake despite the acknowledged high willingness rates, suggesting that residual uncertainty persists despite favorable attitudes toward vaccination.

Scope and limitations

This summary is based on the study abstract and available metadata. It does not include a full analysis of the complete paper, supplementary materials, or underlying datasets unless explicitly stated. Findings should be interpreted in the context of the original publication.