Evidence-based practices are effective in increasing smoke-free home rules among Black women who smoke.

Children younger than 5 years, and especially those younger than 2 years, are at higher risk of serious influenza-related complications [, ]. Vaccination is an effective strategy in preventing influenza and, since 2008, has been recommended by the Advisory Committee on Immunization Practices (ACIP) for all children 6 months–18 years [, ]. Despite this well-established recommendation and a Healthy People 2030 target of 70% influenza vaccination coverage, an estimated 55.4% of children 6 months–17 years were vaccinated against influenza during the 2023–24 influenza season [, ]. Influenza vaccination coverage among children had been 63.7% during the 2019–20 season but declined during the COVID-19 pandemic and has continued to trend downward []. During the 2022–23 season, nearly one-third of children 6 months–17 years had a parent who indicated being hesitant about influenza vaccine for their child []. Understanding the reasons why parents choose not to get their children vaccinated against influenza can help immunization programs and providers tailor interventions and increase parental vaccine confidence and uptake of influenza vaccine among children. Reasons for non-receipt of influenza vaccination (or “non-vaccination”) can change over time and there may have been a shift in reasons from pre-COVID-19 pandemic to the current post-pandemic environment. The objectives of this study were to: 1) estimate percentages of children 6 months–17 years not vaccinated against influenza whose parent reported selected reasons for not having the child get an influenza vaccination at the national level and at the state level, 2) assess whether there has been an increase or decrease in the parental reporting of each reason for non-vaccination over time, examining whether the proportions changed pre versus post pandemic, and 3) assess if parental reasons for non-vaccination differ by sociodemographic characteristics. Data from the National Immunization Survey-Flu (NIS-Flu) from 2015−2024 were analyzed to assess parental reasons their child did not receive an influenza vaccination during the 2015–16, 2016–17, 2019–20, 2022–23, and 2023–24 influenza seasons [, ]. The NIS-Flu is an on-going, national random-digit-dialed cellular telephone survey of households with children; it was a dual landline and cellular telephone survey until January 2018 when it became a cellular only telephone survey [–]. The NIS-Flu includes three components: the NIS-Child for children 19–35 months, the NIS-Teen for adolescents 13–17 years, and the NIS Child Influenza Module for children 6–18 months and 3–12 years identified during the screening of households for the NIS-Child and NIS-Teen [, ]. Telephone interviews were conducted with adults ≥18 years knowledgeable about the child’s vaccinations (hereafter referred to as “parent”) during October through June for the five seasons from all 50 states and the District of Columbia. The Council of American Survey and Research Organizations (CASRO) response rates ranged from 53.5%–64.8% for landline (2015−16 and 2016−17 seasons only) and 19.6%–32.2% for cellular telephones [].