Improving the immunization coverage of children less than 7 years old in a family practice residency.

William A. Alto · Dianna Fury · Allen Condo · Mary Doran · Michael Aduddell

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Vaccine Coverage and Hesitancy Child and Adolescent Health Pediatric Pain Management Techniques

Abstract

BACKGROUND: This prospective cohort study was designed to evaluate the effectiveness of mail and telephone contact with parents as a means to improve the immunization coverage of children less than 7 years old in a family practice residency clinic. METHODS: Immunization records for 519 children enrolled in an outpatient clinic were reviewed and updated. Children whose immunizations were current (55) were excluded, which left 464 children whose immunizations were more than 1 month behind for their age groups. A random sample of one-half of these children (231) were mailed a postcard listing the immunizations that they required to be up to date. The mailing was followed up with telephone contact, when necessary, to prompt compliance. The other one-half of the children were not contacted and served as the control group. Immunizations provided to the two groups were compared 6 months after the initial mailing. RESULTS: Before the initiation of the study, only 10.6 percent of the infants and children in the practice had their immunizations completed or were up to date. There were 124 immunizations given to 49 children in the intervention group compared with 84 immunizations to 33 children in the control (P < 0.047). Thirty-four children were brought up to date in the control group compared with 17 in the intervention cohort (P < 0.011). CONCLUSIONS: Direct mail reminders and telephone contact with parents of children who were behind in their immunizations were effective methods to encourage compliance. The increased number of immunizations received by the children in the intervention group was overshadowed by the poor coverage of the entire practice, a highly mobile and predominantly indigent group. Additional interventions are urgently needed to improve immunization levels in infants and children.

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References

1988Vaccination of high-risk patients for influenza. A comparison of telephone and mail reminder methods.1980Effectiveness of a mailed reminder on the immunization levels of infants at high risk of failure to complete immunizations.1991The state of the world's children 1991 1987Increasing influenza vaccination among high-risk elderly: a randomized controlled trial of a mail cue in an HMO setting.1985Influenza vaccination in the elderly: 2. The economics of sending reminder letters.

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2017Immunization in the United States 2022Family-centred interventions for Indigenous early childhood well-being by primary healthcare services 1998Evidence on Office-Based Interventions to Improve Childhood Immunization Delivery 1999Public health in managed care: a randomized controlled trial of the effectiveness of postcard reminders.2008Immunization in the United States 2012Randomized Controlled Trial of an Immunization Recall Intervention for Adolescents

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