Validity of parental report of influenza vaccination in young children seeking medical care

Background: Despite frequent use of self-reported information to determine pediatric influenza vaccination coverage, little data are available on the validity of parental reporting of their child's influenza vaccination status and on factors affecting its accuracy. Methods: We compared parent reported influenza vaccination of children to documented reports of vaccination collected from medical records (the criterion standard) among children aged 6-59 months who presented to selected hospitals, emergency departments, and clinics in three U.S. counties with acute respiratory illness during three influenza seasons (November through May of 2004-2007). Demographic and epidemiologic data were collected from chart reviews and parental surveys. Results: Among 3072 children aged 6-59 months, 47.5% were reported by the parent to have received influenza vaccine and 39.5% of children had medical record verification of influenza vaccination. Sensitivity and specificity of parental reporting was 92.1% and 82.3%, respectively, when compared to the immunization record. However, 17.7% of children whose parents reported vaccination had no influenza vaccination documented in their medical records, and this proportion was even higher at 28.6%, among children with an underlying high-risk medical condition. Greater reporting accuracy was associated with younger age of child (6-23 months vs. 24-59 months), white non-Hispanic race/ethnicity, having health insurance, and having a mother with a college education. Conclusions: Our findings indicate that although parental report of influenza vaccination is fairly reliable (similar to 76-96%), over reporting by parents often occurs and immunization record review remains the preferable method for determining vaccination status in children. Published by Elsevier Ltd.