Influenza vaccination rates in children: a multicenter nationwide study

Background. Influenza remains a major cause of morbidity and mortality in children worldwide, yet vaccination coverage is still suboptimal in many countries. We aimed to understand parental awareness, attitudes, and determinants of vaccine uptake to guide effective strategies for increasing coverage and protecting vulnerable pediatric populations. Method. A cross-sectional study was conducted between October 2023 and May 2024 in 38 hospitals across 23 provinces in Türkiye. Data were collected from 5002 families through face-to-face interviews, with 4404 valid responses analyzed. Results. The overall influenza vaccination rate among children was 4.4% (n=195/4404). Vaccination coverage was slightly higher in high-risk groups compared to non-high-risk groups (5.2% vs. 3.5%, p=0.003). Factors positively associated with vaccination uptake included the presence of chronic illness in the child (15.1% in vaccinated vs. 4.7% in unvaccinated, p<0.001), higher parental education levels, and parental history of influenza vaccination (42.8% vs. 4.4%, p<0.001). Logistic regression identified poor attendance at routine pediatric check-ups, lack of awareness of influenza vaccination, and absence of private vaccination as the strongest predictors of non-vaccination. Conclusion. Parental education and physician recommendation are the strongest determinants of childhood influenza vaccination. Embedding vaccination counseling into routine pediatric visits and implementing awareness strategies may help improve uptake, particularly in high-risk children.