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Vaccine Hesitancy · Journal article
Human Vaccines & Immunotherapeutics · August 3, 2026
Early or partial results. Treat as a signal, not a conclusion.
This single-centre cross-sectional survey of 101 parents of children with special health care needs in Shanghai found that parental preference for immunization advisory clinic settings is shaped primarily by child sex and household income rather than vaccine hesitancy alone. The study suggests that hybrid hospital-community delivery models may address vaccination inequity in medically complex children, but the findings are preliminary and localised to one tertiary centre.
Cross-sectional survey. Parents of children with special health care needs aged younger than 14 years with incomplete National Immunization Program schedules attending the immunization advisory clinic at Children's Hospital of Fudan University, Shanghai.. Intervention: Questionnaire on parental preference for immunization advisory clinic settings and associated factors. n = 101. Children's Hospital of Fudan University, Shanghai, China.
51.0% of parents preferred community clinics, 25.7% preferred children's hospitals, and 23.3% preferred general hospitals for IAC setting Parents of girls were significantly more likely to prefer general hospitals (adjusted RRR 7.02; 95% CI 1.50–32.77) Lower household income was associated with reduced preference for general hospitals (adjusted RRR 0.14; 95% CI 0.03–0.75)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians and immunization programme planners should recognise that parental IAC setting preferences among families of medically complex children are driven by socioeconomic and child demographic factors rather than vaccine hesitancy alone. This finding supports investment in hybrid hospital-community vaccination delivery models and standardised referral pathways to improve equity.
Single-centre cross-sectional survey with small sample (n=101) describing parental preferences without a comparator arm or intervention, limiting generalizability and strength of causal inference.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians and immunization programme planners should recognise that parental IAC setting preferences among families of medically complex children are driven by socioeconomic and child demographic factors rather than vaccine hesitancy alone. This finding supports investment in hybrid hospital-community vaccination delivery models and standardised referral pathways to improve equity.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Children with special health care needs (CSHCN) face persistent immunization inequity despite high overall childhood vaccination coverage. Immunization advisory clinics (IACs) have expanded in China, yet parental preferences for different IAC settings remain poorly understood. This cross-sectional survey was conducted at the IAC of Children's Hospital of Fudan University, Shanghai, between October and December 2023. Parents of CSHCN younger than 14 y with incomplete National Immunization Program schedules were invited. The primary outcome was parental preference for IAC setting (community clinic, general hospital, or children's hospital); the secondary outcome was preferred vaccination-assessment provider under discordant recommendations. Multinomial and binary logistic regression models identified associated factors, adjusted for child, parent, and vaccine-attitude covariates. Sensitivity analyses were stratified by medication status. Reporting followed the STROBE statement. Of 102 questionnaires, 101 were valid (99.0% response rate). 51.0% of parents preferred community clinics, 25.7% preferred children's hospitals, and 23.3% preferred general hospitals. Parent Attitudes about Childhood Vaccines (PACV) score was not independently associated with setting preference. Parents of girls were more likely to prefer general hospitals (adjusted RRR, 7.02; 95% CI, 1.50-32.77), whereas lower household income was associated with reduced preference for general hospitals (adjusted RRR, 0.14; 95% CI, 0.03-0.75). Sensitivity analyses yielded consistent findings. Parental preferences for IAC settings among CSHCN families are shaped by child and socioeconomic characteristics rather than by vaccine hesitancy alone. Hybrid hospital-community delivery models and standardized referral pathways may improve vaccination equity for medically complex children.
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