Predictors of childhood immunization completion in a rural population

Gore, Prasanna; Madhavan, Suresh; Curry, David G.; McClung, Gordon W.; Castiglia, Mary; Rosenbluth, Sidney A.; Smego, Raymond A.

doi:10.1016/s0277-9536(98)00410-9

Cited by 54 publications

(42 citation statements)

References 15 publications

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“…Additional factors previously noted in the literature to be associated with vaccination coverage were also entered into the models due to their potential theoretical importance. Such factors included child age, maternal age, maternal education, presence of a personal doctor or nurse, accessibility of services and discontinuous insurance coverage [15,[30][31][32][33]. All analyses were performed using SPSS version 17.0 (SPSS Inc. Chicago, Ill).…”

Section: Discussionmentioning

confidence: 99%

“…The 2004-2005 season was the earliest season that the oldest child (36 months) included in the study was first eligible for influenza vaccination. Key independent variables included child and caregiver socio-demographic characteristics noted previously to be associated with routine vaccination coverage were also assessed, including child's age, gender, race/ethnicity and health insurance status as well as, caregiver age, educational attainment, marital status, income and English proficiency [14][15][16]25]. Of note, English proficiency was determined through caregiver self-report of their ability to speak English, the preferred method to measure the role of language barriers on access to health services [26].…”

Section: Methodsmentioning

confidence: 99%

“…Given the extraordinarily low likelihood of minority children receiving even one influenza vaccine dose, it is important to understand the factors among young black and Latino children that would potentially prevent or, conversely, facilitate receipt of influenza vaccination in the first few seasons a child is eligible [14][15][16][17]. Moreover, children who miss opportunities for vaccinations early on in life are at heightened risk for further missed vaccinations [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

et al. 2011

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Few studies have examined potential factors that contribute to low influenza vaccination rates among minority children. This study aimed to assess the prevalence of early childhood influenza vaccination among young black and Latino children, living in inner-city neighborhoods, and examine the effects of child, caregiver and health system factors. Secondary data analysis was performed using a survey about medical home experiences conducted from May 2007-June 2008. The study sample was limited to children ≥6 months in any influenza season prior to the 2006-2007 influenza season. Bivariate analyses and multivariable logistic regression tested associations between influenza vaccination receipt and socio-demographic and health system characteristics. One-third of children received an influenza vaccination by the end of 2006-2007 season, while only 11% received a vaccination within their first season of eligibility. Black children were more likely than Latino children to have been vaccinated (50% vs. 31%, P<0.01) during their first few eligible seasons. Children whose mothers were older, proficient in English, and frequent users of healthcare were more likely to obtain vaccination. Child attendance at healthcare settings with immunization reminder systems was also positively correlated with influenza vaccination. Our findings suggest that initial vaccination receipt among minority children from inner-city communities might be improved by expanded influenza promotion activities targeting younger mothers or those with limited English proficiency. Strategies to increase the frequency of child's actual contact with the medical home, such as reminder systems, may be useful in improving uptake of influenza vaccination among inner-city, minority children.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

et al. 2011

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“…8 On the other hand, some investigators have reported poor staff attitude and poor quality vaccination services as reasons for defaults in some immunization clinics. [14][15][16] In 6.3% of cases, vaccination defaults were attributed to health workers' misconception about contraindications to vaccination, which may lead to missed opportunity. The role of missed opportunity in vaccine default has been reported by other investigators.…”

Section: Discussionmentioning

confidence: 99%

Vaccination default rates among children attending a static immunization clinic in Benin City, Nigeria

Onyiriuka¹

2009

Journal of Medicine and Biomedical Research

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Immunization coverage among infants in Nigeria continues to be low despite availability of effective vaccines and accessibility of immunization clinics in urban areas. This study was conducted to determine the vaccination default rate and vaccine schedule that is most frequently defaulted. It also documented reasons for the defaults and suggested ways of minimising them. The immunization status of 174 children aged 9-11 months were determined by interviewing mothers regarding their children's immunization histories. Each child's immunization card was subsequently reviewed for confirmation. Overall default rate for the entire recommended series of vaccines was 26.7%. Measles vaccine was the most frequently defaulted. The commonest reason given by respondent mothers for defaulting immunization clinic appointments was the child's ill-health (37.5% of all cases). Immunization clinic appointment default rate is still high in Benin City, with measles vaccine being the most frequently defaulted. We therefore suggest ways of minimising vaccination clinic appointment defaults.

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“…Minorities and the poor have higher rates of not being up to date than do wealthier or white children. [5][6][7][8][9][10][11] The consequence of incomplete immunization is the persistent occurrence of vaccine-preventable diseases. Many strategies have been recommended to improve immunization rates.…”

mentioning

confidence: 99%

Reminder Cards and Immunization Rates Among Latinos and the Rural Poor in Northeast Colorado

Hicks¹,

Tarr²,

Hicks³

2007

The Journal of the American Board of Family Medicine

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Objective: Immunization rates are static in the United States. Risk factors for not being up to date (UTD) include ethnicity and lower socioeconomic status. Reminder cards increase immunization rates in urban settings. Their effect in poor, Latino, and rural children is unknown.Background: Language-appropriate reminder cards were sent to active patients not UTD listing the vaccines missing; the card served as the physician order for the vaccine. Missed opportunities were addressed through discussion with staff and posters in patient care rooms. UTD rates before and after intervention were measured.Results: Dual-purpose reminder/order cards increased the rate of UTD from 61.3% to 73.4%; children living near the clinic, patients who speak only Spanish, and Latinos overall showed preferential effectiveness. Children eligible to participate in the Vaccines for Children program had similar increases in UTD rates but had lower baseline and final UTD rates than did children not eligible for the Vaccines for Children program. The rate of missed opportunities did not change. The number of children to whom reminder cards needed to be sent for them to become fully immunized is 8 (number needed to treat).Conclusions Immunization rates in the United States have reached a plateau in the last several years; several states, including Colorado, show rates far below national averages.1,2 After steadily rising through the 1980s, minimal improvement was seen in the 1990s. There are many theories as to why this glass ceiling exists. Among them are parental concerns about vaccine side effects and safety, the increasing complexity of the recommended immunization schedule, and competing demands in a busy office setting. Missed opportunities represent a special concern because they occur with high frequency and account for much of the immunization delay seen in practice, specifically for at-risk children. 3,4 It is clear, however, that for some populations, the ceiling is lower than for others. Minorities and the poor have higher rates of not being up to date than do wealthier or white children.5-11 The consequence of incomplete immunization is the persistent occurrence of vaccine-preventable diseases. Many strategies have been recommended to improve immunization rates. [12][13][14][15][16][17][18][19] The Vaccine for Children (VFC) program was developed to help ameliorate the inequities in vaccinations inherent in people living in poverty and to increase minorities' access to free vaccines. 20,21 The use of computer-based vaccine registries is increasing in the United States, with over half of all children younger than 6 years of age enrolled in 2005. 22These registries provide the benefits of accessibility in many patient care settings, thereby decreasing chances that one site will inappropriately vaccinate a child. These and other arguments in their favor have been extensively published. 12,[23][24][25][26] Arguments against these registries include the large labor costs of data entry and inconsistent or incomplete data entry leading...

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Predictors of childhood immunization completion in a rural population

Cited by 54 publications

References 15 publications

Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

Vaccination default rates among children attending a static immunization clinic in Benin City, Nigeria

Reminder Cards and Immunization Rates Among Latinos and the Rural Poor in Northeast Colorado

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