New Zealand school children's perspectives on influenza: listening to young voices in respiratory health.

Abstract

Background: Children play a crucial role in the transmission of influenza, yet their understanding of the virus and its prevention is often overlooked in public health messaging. This study aimed to explore, in the post COVID-19 pandemic era, children's perceptions of influenza, with a focus on understanding their perspectives and giving a voice to their views on the illness.

Methods: Two focus groups were conducted in South Auckland, New Zealand, with a diverse sample of 27 children aged 5-13 years from two schools. Consent was obtained through parental approval and child assent. Using creative activities, including drawings and group discussions, children shared their understanding of influenza, its transmission, symptoms, and their views on non-pharmaceutical interventions (NPIs) and vaccination. Data were analysed qualitatively to identify key themes and insights.

Results: While children generally recognise influenza as a severe illness with symptoms like fever, sore throat, and cough, a small proportion of younger children thought influenza was the same as common cold. Most children were aware of the airborne nature of transmission. Children showed strong awareness of how influenza impacts daily life, such as missing school and social events. Age-specific perceptions were evident in the drawings: younger children focused on symptoms, while older children had a broader view, including symptoms, transmission, prevention, and emotional and social impacts. Preferences for NPIs varied by age, with younger children emphasising coughing etiquette and older children prioritising handwashing and mask-wearing. Regarding vaccination, while children understood its protective role, many expressed fear of injections, preferring less invasive options like nasal sprays or patches.

Conclusion: Children's perceptions of influenza highlight both awareness and gaps in understanding, particularly regarding transmission and illness severity. Public health messaging that addresses both these strengths and gaps, while incorporating children's voices, could improve efforts to mitigate the impact of influenza and other respiratory illnesses. Strategies such as promoting alternative vaccination methods and reinforcing NPIs in a relatable way may enhance children's engagement with health behaviours, contributing to more effective influenza control in schools and communities.