The European Center for Disease Control and Prevention (ECDC) identified young children as a group at higher risk of developing severe pandemic influenza A (H1N1) 2009 infection compared with the general population. Since children have high attack rates and seem essential in augmenting local outbreaks of influenza, vaccination of children was an important objective in the Swedish pandemic influenza A (H1N1) 2009 vaccination campaign. Children < 13 years of age were recommended to take two doses of the pandemic vaccine (Pandemrix®).

The objective of this study was to compare the vaccination coverage among children 1–12 years of age in different councils in the County of Jämtland, Sweden that either implemented an active advocating or a passive vaccination strategy. The active strategy included direct information to parents promoting vaccination, individual appointments, collaboration between different care providers, and visits of vaccination teams to day care centers and schools, whereas no specific measures, except general information in press and media, were undertaken in councils using a passive approach.

All pandemic vaccinations in the County of Jämtland were registered in a Web-based registration software system. Vaccine coverage was determined by comparing the actual number of children residing in different councils with the number of vaccinated children.

A total of 4,162 of 6,000 children (69.3%) residing in councils using an active vaccination strategy were vaccinated compared with 5,059 of 9,373 children (53.9%) living in councils using a passive vaccination strategy (p < 0.0001)

Implementation of an active advocating vaccination strategy during the Swedish pandemic influenza A (H1N1) 2009 vaccination campaign resulted in a significantly higher vaccination coverage rate compared with a passive vaccination strategy.