Although influenza vaccination works and prevents minor and severe illness due to influenza almost half of all children and teens from 6 months to 17 years do not receive influenza vaccine in 2010. This was at the height of influenza concerns due to H1N1 influenza. The highest unimmunized groups are adolescents and black children. School aged children and teens are at the greatest risk of contracting and spreading influenza yet their immunizations rates are low. The reasons are multiple for the low adherence with the American Academy of Pediatrics (AAP) recommendation that annual influenza vaccine be given to all children and teens from 6 months to 18 years.
Barriers to immunization include cost and insurance coverage as well as infrequent visits to doctors. Reminder systems are inadequate and outreach programs to provide low cost and affordable immunizations at accessible and visible locations are inadequate. School based immunization programs and the use of social media, including text messaging directed towards encouraging adolescents to take on the responsibility of obtaining a flu shot to maintain their own health improve immunization rates. Ownership is associated with improved outcomes and immunization compliance for adolescents. Education and availability go hand in hand with success.