Parental Concerns and Attitudes Regarding Influenza Vaccination of Children with Asthma During the COVID-19 Pandemic

Objective: Guidelines recommend annual influenza vaccination for patients with moderate-to-severe asthma. This study aimed to investigate parental opinions and attitudes about influenza vaccination of their children with asthma before and during the COVID-19 pandemic. Materials and Methods: The parents of children (<18 years of age) diagnosed with asthma before September 2019 were interviewed using a standard questionnaire to collect data regarding their children's demographic characteristics, asthma treatment, asthma control status within the last 2 years, and influenza vaccination status during and one year before the COVID-19 pandemic. Results: The patient group included 288 children (60.1% [n=173] males) with a median age of 11 years (interquartile range [IQR]: 8-14). The median duration of asthma follow-up was 6 years (IQR 4-8). Over half of the children (n=166, 57.6%) had at least one influenza vaccination at any time (before/after the pandemic). After COVID-19, the immunization rate increased from 35.7% to 47.2% compared to the previous year, with 63 (21.9%) children not previously vaccinated receiving the influenza vaccine during the pandemic. Those with a history of multiple asthma attacks in the previous year, those at a higher step of asthma treatment, and those with a monthly household income above the minimum wage were more likely to be vaccinated. For children never vaccinated against influenza, the most common reason cited by their parents was that their children were apparently well (40.1%). For children who were not vaccinated during the pandemic despite previous vaccination, lockdown was reported as the main reason (61.5%). Conclusion: COVID-19 affected parental attitudes toward influenza vaccination of their children with asthma. The immunization rate of children increased after COVID-19 compared to the previous year. While the apparent wellness of their child was the most common reason for parental hesitancy toward influenza vaccination before the COVID-19 pandemic, lockdown measures became the most common reason for not vaccinating during the pandemic.