Delays in Childhood Immunizations in Public and Private Settings

William J. Hueston

40 citations0/0 files storedArchives of Pediatrics and Adolescent Medicine

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

Abstract

BACKGROUND: As the costs of childhood immunizations have increased over the past 10 years, patients have increasingly turned to public health departments for this service. This study compares reasons for delays in immunization among patients who obtained their immunizations at health departments and those who continued to utilize private physicians or clinics. METHODS: A birth certificate survey of all children born between September 1, 1988, and August 31, 1989, in four urban census tracts and two rural counties in Kentucky was performed in late 1991, when all children were over age 2 years. The percentage of patients whose immunizations had been delayed and the reasons for delay were noted. RESULTS: Children who utilized public health departments or a combination of health departments and private sources for their immunizations were more likely to have experienced delays than those who obtained immunizations from private providers (56% vs 34%, P = .002). In particular, patients in the public provider group were more likely than those in the private provider group to have missed immunizations for invalid contraindications (34% vs 8%, P = .02), missed appointments (22% vs 9%, P = .02), or failure to receive immunizations when at the health department for another visit (23% vs 11%, P = .04). CONCLUSIONS: While a large number of patients in both the private and public provider groups experienced delays in immunizations, patients who received immunizations from public sources were more likely to experience delays related to missed opportunities.

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References

1991The Measles Epidemic 1993Missed Opportunities for Childhood Vaccinations in Office Practices and the Effect on Vaccination Status 1992Maternal recall error of child vaccination status in a developing nation.1989Measles Outbreak Among Unvaccinated Preschool-Aged Children: Opportunities Missed by Health Care Providers to Administer Measles Vaccine 1992Vaccination Levels and Missed Opportunities for Measles Vaccination: A Record Audit in a Public Pediatric Clinic 1992Monitoring Progress Toward US Preschool Immunization Goals 1991Changing Immunization Referral Patterns Among Pediatricians and Family Practice Physicians, Dallas County, Texas, 1988 1992The Impact of Health Care Financing on Childhood Immunization Practices

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1999Impact of Community Volunteers on Immunization Rates of Children Younger Than 2 Years 2003Evaluation of invalid vaccine doses 2000Decline in physician referrals to health department clinics for immunizations 2004The Regional Immunization Registry as a Public Health Tool for Improving Clinical Practice and Guiding Immunization Delivery Policy

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