According to the Advisory Committee on Immunization Practices, Influenza vaccination is the most effective strategy for preventing influenza infection. Since 2002, children’s influenza vaccination recommendations have been changed numerous times, and as of 2008, all children aged 6 months to 18 years are included. Despite this, flu vaccination rates have remained low. In the spring of 2007, Researchers surveyed practicing doctors in Maryland to investigate their attitudes and practices regarding childhood influenza vaccination. The poll received a total response rate of 21%. Immunization is either cost neutral or causes a loss for 61 % of respondents, and 36.6 % said it is marginally profitable. 86% of those polled said they would support school-based immunization programs, and 61% said they would engage in them. The immunization rates of some patient categories reported by respondents were greater than those reported by the Centers for Disease Control and Prevention. 

Vaccination was reported at various patient contacts, as was advised. According to survey respondents, practice-based immunization is not a good service. Pediatricians were enthusiastic about school-based immunization programs, with more than half stating that they would participate actively. School-based immunization initiatives may be crucial to ensuring high vaccination coverage among school-aged children.