Search Results (1,116)

Background/Objectives: Despite high vaccination coverage, influenza remains a public health concern in South Korea, particularly in older adults. Continuous evaluation of vaccine effectiveness (VE) is essential to optimize immunization strategies. Methods: This study evaluated seasonal influenza VE for preventing laboratory-confirmed influenza using a test-negative design through a hospital-based influenza surveillance system in South Korea from 1 November 2024, to 30 April 2025. Demographic and clinical information was collected through questionnaire surveys and electronic medical records. Influenza was diagnosed using rapid antigen tests (RATs) and reverse transcription polymerase chain reaction (RT-qPCR), and vaccine effectiveness was analyzed using multivariable logistic regression. Results: In total, 3954 participants were included, with 1977 influenza-positive cases and 1977 test-negative controls. Influenza A and B accounted for 93.1% and 7.0% of cases, respectively. The adjusted overall VE was 20.4% (95% confidence interval [CI], 8.2–30.9; p = 0.002). VE was higher in adults aged 50–64 years (46.8%) than in those aged ≥65 years (18.8%). VE was 19.9% against influenza A and 45.7% against A/H3N2. VE was higher among individuals tested using RT-qPCR than among those tested using RATs (21.5% vs. 15.7%), and was also greater during the early period than during the late period (20.5% vs. 11.4%). Vaccination did not reduce influenza-associated hospitalization risk (VE, 17.3%; 95% CI, −9.3 to 37.4). A significant reduction in hospitalization risk was observed in adults aged 50–64 years (VE, 46.8%), with no significant benefit in those aged ≥65 years. Conclusions: The 2024–2025 seasonal influenza vaccine provided moderate protection against laboratory-confirmed influenza in adults, with higher effectiveness in those aged 50–64 years. Full article

One of the challenges post-COVID-19 is reducing the negative impacts on quality of life, performance, and independence in activities of daily living. Assessing functional dependence in adults one year after acute infection can help to understand the long-term consequences, evaluate the impact on quality of life, plan rehabilitation and healthcare, identify the most vulnerable groups, measure the socioeconomic impact, and support public policies and clinical decisions. Objectives: The objectives of this study are as follows: (a) to assess the prevalence of functional dependence in Brazilian adults with COVID-19; (b) to analyze the association between the study variables; and (c) to determine the factors associated with functional dependence. Methods: This was an observational, cross-sectional study with 987 adults (18 to 59 years old) living in the State of Paraná (Brazil) hospitalized for COVID-19 between March and December 2020. Data were collected by telephone 12 months after the acute infection using an instrument to retrieve sociodemographic and health information, and a functional dependence scale to assess dependence before COVID-19 retrospectively (using participant recall information) and at the time of the interview. Data were analyzed using penalized logistic regression after imputing missing data. Data were analyzed using penalized logistic regression after imputing missing data. Results: Functional dependence after COVID-19 was 5.0% and was associated with low levels of education, not having a partner, living with someone, not owning a home, experiencing job changes, requiring care, obesity, smoking, multimorbidity, ICU admission in the acute phase, use of invasive ventilation, or having Long COVID. Individuals who required care or used invasive ventilation support were, respectively, 9.3 and 6.5 times more likely to develop dependence after COVID-19. Despite adjustment for multiple factors, the magnitude of the observed effects warrants cautious interpretation, as unmeasured or residual confounding effects may still be present. Sample recall bias due to collection after 12 months and the presence of the alpha variant without COVID-19 vaccination coverage may limit data generalization. Conclusions: The results highlight the need to emphasize the public health implications of identifying functional dependence. In this vein, it is necessary to implement preventive measures, identify and monitor more vulnerable groups, plan rehabilitation programs, and develop public health policies. Full article

Background: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in the elderly. While pneumococcal vaccination is a core preventive measure, it remains unclear whether its association with severe CAP is uniform across all elderly subgroups. Our study aimed to evaluate the overall association of pneumococcal vaccination with the risk of severe CAP in hospitalized patients aged ≥ 65 years and to explore potential heterogeneity in this association using a causal forest model. Methods: We conducted a retrospective cohort study of patients discharged between January 2023 and June 2025, aged ≥ 65 years, with a primary diagnosis of CAP. We used multivariable logistic regression to estimate the average association and a causal forest model to explore heterogeneous patterns in the conditional average treatment effect (CATE). Results: Among 1906 included patients (severe CAP: 924; non-severe CAP: 982), PPSV23 vaccination was independently associated with reduced odds of all-cause severe CAP (adjusted OR = 0.610, 95% CI: 0.401–0.930). The causal forest model yielded an average treatment effect (ATE) estimate of −0.112 (95% CI: −0.200 to −0.023), corresponding to an 11.2 percentage-point reduction in absolute risk. Exploratory analysis suggested potential heterogeneity: the association appeared most pronounced in patients aged 65–74 years (CATE = −0.122) and showed an attenuating trend in older groups. Age was the primary variable associated with heterogeneity, followed by hypertension, SARS-CoV-2 infection, and sex. Conclusions: In this observational cohort study, PPSV23 vaccination was associated with a reduced risk of severe CAP in elderly inpatients under strong assumptions of no unmeasured confounding. Exploratory analyses suggested potential heterogeneity in this association, which appeared to attenuate with advancing age and may be influenced by comorbidities. These hypothesis-generating findings indicate that further investigation is needed to determine whether prevention strategies should be tailored for the very old and those with specific chronic conditions. Full article

Background: Nirsevimab, a monoclonal antibody for respiratory syncytial virus (RSV), reduces medically attended RSV infections. It was introduced in the 2023–24 RSV season. This study examined the association between caregiver vaccination (seasonal influenza vaccine (SIV), COVID-19, and boosters) and intent to immunize infants against RSV. Methods: Data from 118 caregivers with infants ≤ 8 months were analyzed. Chi-squared tests and logistic regression assessed the relationship between caregiver vaccination and intent to immunize against RSV. Results: In total, 74.6% of caregivers intended to immunize their infants against RSV. Intent was positively associated with caregiver receipt of a seasonal influenza vaccine (p < 0.001), COVID-19 vaccine (p < 0.001), and COVID-19 booster (p < 0.001). Intent was also associated with older child seasonal vaccination. Caregiver receipt of both COVID-19 vaccinations and boosters had a strong relationship with RSV immunization intent (OR 7.91 (1.90–33.0, p = 0.004)). Conclusions: Caregiver vaccination behaviors are linked to RSV immunization intent, helping physicians identify hesitant families and prepare for immunization conversations. Full article

Background/Objectives: Recently, the Herpes Zoster (HZ) vaccination has been introduced, alongside influenza and pneumococcal vaccination, at age 65. Factors influencing adherence to this vaccination and its clinical benefits are not completely understood. The aim of this study was to evaluate factors influencing adherence to HZ vaccination compared to pneumococcal and influenza and to assess its clinical effect in preventing acute vascular events. Methods: A total of 1152 patients (520 males), having a birth cohort from 1952 to 1959 inclusive, was recruited, belonging to the District of Udine (N = 839) and to the ASAPs 2 and 3 of Pordenone (N = 313). For each patient, a form was compiled. Results: HZ vaccination was administered to 498 patients, influenza to 665, and pneumococcal to 742 (p < 0.0001). Among the vaccinated, 266 received the live-attenuated version, and 232 the recombinant HZ vaccine. In logistic regression, the presence of addictions, low educational level, and poor socioeconomic status were strongly associated with lower vaccine adherence. The presence of chronic diseases enhanced only pneumococcal (p < 0.001) and influenza (p < 0.001) vaccine adherence. Forty-two non-fatal acute vascular events were recorded from age 65 onwards: 14 cardiac, 20 cerebrovascular, and 8 peripheric. Only 6/493 patients experienced an event following HZ vaccination compared to 36/659 unvaccinated subjects (p = 0.0003). In Cox modeling, HZ vaccination proved to be an independent predictor in preventing subsequent acute vascular events (p < 0.001). Conclusions: The presence of pathologies does not enhance adherence to HZ vaccination while an unfavorable socio-environmental context greatly hinders it. HZ vaccination, but not influenza and pneumococcal vaccination, appears to protect against the occurrence of acute vascular events. Full article

The COVID-19 pandemic has been one of the most globally disruptive social events in recent history, bringing widespread lockdowns, restrictions on movement, remote work, mass vaccination campaigns, and millions of deaths worldwide. These unprecedented circumstances have reshaped many aspects of social life, including perceptions of safety and firearm ownership. This study examines changes in reported gun ownership before and during the COVID-19 pandemic in the United States, using binary logistic regression analyses of General Social Survey (GSS) data from 2018 and 2021. Analysis revealed that reported gun ownership remained stable at approximately 35% in both years. However, the demographic and social profile of gun owners shifted significantly. Demographic factors such as sex, US birth, marital status, and income consistently predicted ownership in both years, while race, middle-class identification, and political party affiliation emerged as significant predictors only during the pandemic, with Democrats becoming significantly less likely to report gun ownership. The results demonstrate how social crises can reshape the composition of firearm owners rather than overall rates, with implications for public policy and safety. Full article

Background/Objectives: Healthcare workers (HCW) in primary care settings play a significant role in recommending vaccines to patients. We aimed to describe COVID-19 vaccination knowledge, attitudes, perception, and practices (KAPP) of HCWs in Tunisia and identify associated factors. Methods: We conducted a national cross-sectional survey (29 January to 3 February 2024) among HCWs in primary public healthcare centers using purposive sampling. Factors associated with good knowledge, positive attitude, and good practice, measured through Likert scales using face-to-face questionnaires, were identified using binary logistic regression. Results: We included 906 HCWs (mean age = 41.87 ± 8.89 years). In total, 37.75% (342/906) of HCWs had good knowledge and perception, 4.30% (39/906) had a positive attitude, and 24.9% (226/906) had good practices related to COVID-19 vaccination. Working in urban compared to rural areas was associated with good knowledge (aOR = 1.57, 95%CI = 1.12–2.21) and positive attitude (aOR = 4.94, 95%CI = 1.19–20.44) to COVID-19 vaccination. Physicians had better KAPP scores than other medical professionals. HCWs working in departments with high-risk patients were more likely to have good knowledge (aOR = 1.28, 95%CI = 1.00–1.72). Positive attitude was also associated with being male (aOR = 2.97, 95%CI = 1.75–5.07) and having at least one non-communicable disease (aOR = 1.92, 95%CI = 1.14–3.23). Being male (aOR = 1.97, 95%CI = 1.35–2.88) and having more years of professional experience (aOR = 1.81, 95%CI = 1.29–2.52) were associated with good practice. Conclusions: Just over a third of HCWs in primary healthcare clinics had good knowledge of COVID-19 vaccination, while positive attitudes and good practices were low. Targeted interventions, particularly for HCWs with less professional experience working in rural settings, are needed to increase good practices and improve COVID-19 vaccination coverage in Tunisia. Full article

Objective: In the context of an aging population, the prevention and control of cognitive impairment is a key public health priority. This study aims to investigate the association between proactive health behaviors and the risk of AD8 screening positivity in older adults in China, providing an empirical basis for developing targeted intervention strategies. Methods: Based on health behavior data from 1110 older adults in China, the chi-square test was used to analyze the differences in proactive health behaviors (such as limiting salt and alcohol intake, smoking cessation, and vaccination) between the low-risk and high-risk groups for AD8 screening. Factor analysis was used to extract the main factors of proactive health behaviors. Firth penalized logistic regression models were used to analyze the impact of the main factors and sociodemographic factors on the risk of cognitive impairment. Results: The chi-square test showed that there were significant differences between the two groups in salt restriction behavior (χ² = 18.063, p < 0.01) and vaccination (χ² = 29.674, p < 0.01), with a higher proportion of salt restriction (34.7%) and vaccination rates (80.4%) in the low-risk group. Factor analysis extracted four main factors (psychological–social support, information–behavior execution, technology–environment promotion, and addictive behavior control), with a cumulative variance contribution rate of 58.45%. Among them, psychological–social support (31.42% explained variance) and information–behavior execution (28.04%) had the strongest explanatory power. Firth penalized logistic regression showed that psychological–social support (Firth-corrected OR = 0.072, 95% CI: 0.035–0.148, p < 0.01) and information–behavior execution (Firth-corrected OR = 0.008, 95% CI: 0.003–0.021, p < 0.01) had significant protective effects on AD8 screening positivity (standardized OR values indicated that each one-standard-deviation increase in these two factors reduced screening-positive risk by 39% and 53%, respectively), and the risk increased by 21.7% for every 5-year increase in age (OR = 1.217, p = 0.001). Technology–environment promotion (OR = 0.417, 95% CI: 0.250–0.691, p = 0.001) and addictive behavior control (OR = 0.709, 95% CI: 0.490–1.026, p = 0.068) showed no significant protective effects. Sensitivity analysis confirmed the robustness of the four-factor structure and core conclusions. Conclusions: Among proactive health behaviors, psychological–social support and information–behavior execution are key protective factors in reducing the risk of AD8 screening positivity in older adults, and age is an important influencing factor. Strengthening psychological support and optimizing access to health information and behavior execution can serve as core strategies for cognitive impairment prevention and control, providing empirical support for the formulation of health policies for older adults. Full article

Background: Canine leishmaniasis is notoriously difficult to manage by chemotherapy alone, necessitating the consideration of supplemental or alternative treatment. Evidence is presented to support the feasibility of immunotherapy of diseased dogs through vaccination. Methods: The vaccine format used consisted of cultured promastigotes of Leishmania infantum, which were rapidly and completely killed by intracellularly generated singlet oxygen. A total of 33 owned dogs of different breeds and ages diagnosed positive for leishmaniasis were enrolled and divided into three groups for treatments as follows: (1) immunotherapy alone (9 dogs); (2) immunotherapy after chemotherapy (14 dogs); and (3) chemotherapy alone (10 dogs). All dogs in Groups 1 and 2 received intradermally three identical dosages of the vaccine format mentioned at the same schedules. The outcomes were assessed for one year at a post-treatment interval of 2–4 months by determining lymph node parasite loads and clinical scores based on established methodologies. Results: Spaghetti plots of the values for parasite loads obtained revealed that they scattered widely over time with a significant decline by 8–12 months post-treatment in all three groups. Sankey plots of clinical scores in stacked bars also showed that they followed erratic patterns of flow over time, albeit toward lower levels in all cases. Ordinal logistic regression analysis of clinical scores indicated that, while the odds for the emergence of severe clinical symptoms declined in all three groups, the lowest risk was associated with Group 2 dogs treated with immunotherapy after chemotherapy. The evidence presented thus suggests that immunotherapy of the diseased dogs with the vaccine format diminished their parasite loads and improved their clinical scores, especially when applied after chemotherapy. Dogs in Groups 1 and 2 that received immunotherapy, on average, lived twice as long as those in Group 3 that received chemotherapy alone. The risk of death estimated by analysis of the clinical scores using the Cox proportional hazard model was also found to be lower for Groups 1–2 dogs receiving immunotherapy than those in Group 3 receiving chemotherapy alone. Conclusions: Post-therapeutic survival time thus may be an additional parameter suitable to assess treatment efficacy by vaccination. In vitro approaches to mitigate some limitations of this study were proposed for future investigation. Full article

Background: Cervical cancer is associated with Human Papillomavirus (HPV) infection. Besides cervical cancer, oro-pharyngo-laryngeal or uro-genital cancers are also reported. The HPV vaccine has been strongly recommended for school age children. However, the parents’ or guardians’ hesitancy remains. Methods: This is a mixed-method study in which the parents or guardians of school children, aged 10–18 years, were enrolled voluntarily. Their general demographic data, knowledge, attitudes, and awareness of vaccine accessibility, healthcare cost entitlement of the children, types of school affiliation, education administration areas where the schools were located, and the presence of a healthcare professional in family were analyzed by multiple logistic regression analysis adjusted with all studied variables to define the significant associated factors with the parents’ or guardians’ HPV vaccine acceptance (p < 0.05). In-depth interviews were subsequently performed with the selected participants until the qualitative data were saturated. Thematic analysis was applied, and the results of the two study methods were integrated to explore the reasons for vaccine acceptance or hesitancy. Results: A total of 943 questionnaire respondents were enrolled, among whom 75.8% were female and 86.4% were parents. A total of 663 (70.3%) participants accepted the HPV vaccine. Parents’ or guardians’ knowledge and attitudes, awareness of vaccine accessibility, type of school affiliation, the children’s healthcare cost entitlement, and the presence of a healthcare professional in the family were significantly associated with vaccine acceptance in the multivariate analysis (p < 0.05). The qualitative study revealed that misunderstanding of the vaccine’s safety and benefits combined with inadequate reliable information sources were associated factors with HPV vaccine hesitancy among the parents or guardians. Conclusions: Providing clear-cut knowledge about the HPV vaccine benefit vs. risk and clearing financial barriers for the parents or guardians of school children are advocated. Full article

Background: Women’s empowerment has been significantly associated with improved child health outcomes. Cambodia, amid a rapid socioeconomic transition, offers a critical setting to examine how advancements in women’s empowerment over the past decade have influenced child immunization completion within the first two years of life. Methods: Data from the Cambodia Demographic and Health Surveys conducted in 2010, 2014, and 2021–22, encompassing 9222 women with recent births, were analyzed. Empowerment was measured across literacy and information access, employment, and decision-making domains. Multinomial logistic regression assessed associations between empowerment factors and completion of oral polio (OPV), diphtheria–tetanus–pertussis (DTP), pneumococcal conjugate (PCV), and measles–rubella (MR) vaccines, adjusting for demographic and socioeconomic variables. Results: Between 2010 and 2022, women’s empowerment in Cambodia improved significantly, marked by higher literacy rates, nearly half of women completing primary education, and expanded digital access, with 82.4% owning mobile phones and approximately 50% using the internet daily. While non-working women slightly increased, agricultural employment declined by 20%, and cash earnings rose from 48.7% to 82.5%. Most women participated in major household decision-making, either independently or jointly. Completion rates for OPV, DTP, and PCV ranged from 79% to 83%, while just over half of children were fully vaccinated against measles. Higher maternal education and cash earnings were positively associated with OPV, DTP, and PCV completion but negatively associated with measles vaccination. Women in agricultural work were less likely to complete measles vaccination for their children than non-working women. Joint decision-making regarding the use of respondents’ income was associated with a higher likelihood of measles non-completion (OR = 2.26, 95% CI: 1.13–4.51), whereas joint decision-making about respondents’ health care was associated with a higher likelihood of measles completion (OR = 0.42, 95% CI: 0.21–0.83). Conclusions: Women’s empowerment remains a key determinant of vaccination outcomes in Cambodia. The distinct pattern observed for measles suggests that vaccines scheduled for older ages encounter greater structural and behavioral barriers. To overcome these challenges, strategies should focus on enhancing defaulter tracking, implementing reminder systems, expanding outreach and catch-up programs, and improving the convenience of vaccination services. Full article

Background/Objectives: COVID-19 mRNA vaccines protect against hospitalization, but less is known about real-world vaccine effectiveness (VE) against other severe outcomes. Methods: We enrolled adults hospitalized with acute respiratory illness at two hospitals in Atlanta, Georgia, USA from May 2021 to January 2023. Participants were eligible if they had standard-of-care COVID-19 testing or provided an upper respiratory swab for analysis. Vaccination status was confirmed through the state registry. mRNA COVID-19 VE among those with severe outcomes was determined using a test-negative case–control design with stepwise logistic regression adjusting for confounding variables. Results: Of 1973 participants eligible for analysis, 886 (44.9%) were unvaccinated, 641 (32.5%) received a primary series, and 446 (22.6%) received a primary series plus ≥ 1 booster. A total of 734 (37.2%) were positive for COVID-19. During the pre-Delta/Delta (2 May 2021–19 December 2021) vs. Omicron (20 December 2021–31 January 2023) eras, adjusted COVID-19 mRNA VE of a primary series compared to no vaccination was 85.5% (95% CI: 77.0%, 90.8%) vs. 38.2% (95% CI: 11.5%, 56.8%) overall, 90.0% (95% CI: 82.6%, 94.2%) vs. 54.4% (95% CI: 9.0%, 77.1%) among those with radiographic pneumonia, and 94.4% (95% CI: 80.5%, 98.4%) vs. 62.5% (95% CI: 19.0%, 82.7%) among those admitted to the ICU. VE against severe outcomes was highest within the 6 months following vaccination and during the pre-Delta/Delta era. A booster dose partially restored VE against Omicron-associated hospitalization and pneumonia. Conclusions: COVID-19 mRNA vaccines were effective at preventing hospitalization and other severe outcomes in adults during periods of pre-Delta/Delta and Omicron variant circulation. Full article

Background/Objectives: It is critical to monitor real-world COVID-19 vaccine effectiveness (VE) in older adults, as they have been identified as a priority group for vaccination. This is the first study that aims to estimate national absolute vaccine effectiveness (aVE) against severe COVID-19 outcomes among Canadian older adults aged ≥50 years. Methods: The screening method (SM) was implemented using standard and spline-based logistic regression models to estimate aVE and 95% confidence intervals (CIs) by outcome, age group, vaccination status, time since last dose, vaccine schedules, and variant of concern (VOC) period. Results: From 1 August 2021 to 30 November 2023, there were 103,822 severe COVID-19 cases, of which 72.9% were hospitalized, 8.2% were admitted to ICU, and 18.9% had died. A total of 23.1% of these cases were unvaccinated against COVID-19, 21.9% completed a primary series only, and 55.0% received at least one additional/booster dose. National aVE against severe COVID-19 outcomes remained moderate to high during Delta and original Omicron VOC predominance periods. Monthly age-specific aVE of at least two additional/booster doses remained stable during recombinant XBB.1.5/EG.5 VOC predominance, ranging from 61.0% (95% CI: 51.9–68.4%) to 69.8% (95% CI: 67.5–72.0%) against hospitalization, and 71.0% (95% CI: 62.8–77.4%) to 77.2% (95% CI: 74.2–79.9%) against ICU admission/death. Adjusted aVE was higher for last booster doses received within the past six months and with heterologous mRNA vaccine schedules. Conclusions: The SM is a useful method to estimate aVE in near real-time, enabling the assessment of temporal changes in aVE, guiding vaccine policy, and building vaccine confidence among populations at higher risk of severe outcomes. Full article

Objectives: Despite high overall vaccination coverage in Galicia, Spain, human papillomavirus (HPV) vaccine uptake remains below the 90% target set by the World Health Organization for 2030. This study aimed to assess baseline knowledge of HPV and attitudes towards HPV vaccination among Galician adolescents and to evaluate the impact of a brief educational intervention delivered as a “pill of knowledge”. Methods: A quasi-experimental pre-/post-intervention study was conducted among 967 students aged 12–16 years from 16 secondary schools in Galicia during the 2023–2024 academic year. A concise, structured 15-min educational session termed a “pill of knowledge” was delivered, and HPV-related knowledge and vaccination intention were measured immediately before and after the intervention using a standardized questionnaire. Results: Following the “pill of knowledge”, the mean proportion of correct responses increased by 30.1 ± 16.6% across all knowledge items. Among unvaccinated participants, intention to accept HPV vaccination rose from 77.7% to 94.4% in girls and from 64.7% to 85.8% in boys. Pre-intervention predictors of vaccination intention included perceived vaccine efficacy and baseline HPV knowledge. Post-intervention independent predictors comprised being female, younger age (12–13 years), and prior sexual education delivered by teachers or parents. The overall predictive accuracy of the logistic regression model for vaccination intention improved from 75.6% before the intervention to 92.7% afterwards. Conclusions: A brief, school-based “pill of knowledge” produced substantial and immediate improvements in HPV knowledge and vaccination acceptance among Galician adolescents. These findings strongly support the systematic incorporation of short, evidence-based educational interventions of this kind into the school setting as an effective public health measure to increase HPV vaccine coverage and advance progress toward WHO elimination targets. Full article

Background: Promoting seasonal influenza vaccination among parents may help increase the coverage of seasonal influenza vaccination among both parents and children. This study aims to investigate determinants of behavioral intention to receive a seasonal influenza vaccination among parents of children aged 0–15 years to protect themselves. Methods: A cross-sectional survey was conducted among parents of children aged 0 to 15 years with administrative health records in Shenzhen, China, between September and October 2024. Participants were recruited through multistage random sampling. First, 10 community health centers were randomly selected in Shenzhen. Within each selected center, 200 parents were randomly selected. Multivariate logistic regression models were fitted. Results: Among 1504 parents, 47.6% intended to receive a seasonal influenza vaccination in the next year. After adjusting for significant background characteristics, parents’ intention to receive a seasonal influenza vaccination was associated with a higher intention to vaccinate their children against seasonal influenza (AOR: 20.39). At the individual level, eight items measuring illness representations of seasonal influenza were associated with higher odds of intending to receive such a vaccine (AOR: 1.15–1.25), including identity (identifying symptoms), timeline, negative consequences, personal and treatment control, concern, negative emotions, and coherence. At the interpersonal level, parents who had higher levels of general and family-oriented altruism (AOR: 1.10–2.47), better family harmony (AOR: 1.07), higher exposure to information related to seasonal influenza on social media (AOR: 1.24–1.38), and thoughtful consideration of information veracity (AOR: 1.33) were more likely to report an intention. Conclusions: There are strong needs to promote seasonal influenza vaccination among parents in China. Full article