Peer-reviewed article

Parental preference for live-attenuated versus inactivated influenza vaccination in children: A questionnaire survey.

Taito Kitano, Nami Kurosawa, Shinji Hirano, Takumi Okamura, Soshi Hachisuka et al. · 18 Mar 2026

Abstract

Understanding parental attitudes and factors influencing selection of influenza vaccines, including live-attenuated influenza vaccine (LAIV) and inactivated influenza vaccine (IIV), provides insights into optimizing influenza vaccine uptake. This online survey evaluated parental knowledge, attitudes, and preferences regarding influenza vaccination for children and examined the impact of providing vaccine-related information on vaccine selection in Nara, Japan where LAIV was recently introduced. Parents of children aged 2 to 18 y reported vaccination preference before and after reviewing standardized vaccine-related information and provided reasons for vaccine selection. In total, 237 parents answered the questionnaire for 302 children. After review of the vaccine information, 27.8% of parents planned vaccination with IIV and 66.2% planned vaccination with LAIV. Preference for LAIV increased significantly after information review compared with baseline (p < .001). Common reasons for LAIV preference included lack of a second dose requirement (92.4%), absence of injection-related pain (74.0%), and expectation of mucosal immunity development (32.8%). Reasons for IIV preference included no prior experience with LAIV (38.2%), higher cost of LAIV (32.7%), and familiarity with IIV (23.6%). Provision of vaccine information increased parental preference for LAIV for their children, suggesting that improved communication may support greater uptake of LAIV.