Improving Immunization Coverage Rates: An Evidence-based Review of the Literature

Shefer, Abigail; Briss, Peter A.; Rodewald, Lance; Bernier, Roger H.; Strikas, Ray; Yusuf, Hussain; Ndiaye, Serigne M.; Wiliams, Sheree; Pappaioanou, Marguerite; Hinman, Alan R.

doi:10.1093/oxfordjournals.epirev.a017992

Cited by 159 publications

(114 citation statements)

References 160 publications

(267 reference statements)

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“…These include the use of reminder and recall strategies, assessment of vaccination coverage at the provider or clinic level and feedback of information to the provider, and parent and provider education conducted as part of multi-component interventions. 21,26 Numerous studies have documented the effectiveness of these strategies in raising vaccination coverage among children in various settings, including children in urban and inner-city areas. 21,26 For example, a recent review of the effectiveness of parent reminder and recall systems found that children exposed to reminders were twice as likely to be UTD with immunizations as children not exposed to such strategies.…”

Section: Discussionmentioning

confidence: 99%

“…21,26 Numerous studies have documented the effectiveness of these strategies in raising vaccination coverage among children in various settings, including children in urban and inner-city areas. 21,26 For example, a recent review of the effectiveness of parent reminder and recall systems found that children exposed to reminders were twice as likely to be UTD with immunizations as children not exposed to such strategies. 21 By improving office practice for assessing children's immunization status during clinical encounters and administering indicated vaccines, reminder and recall systems as well as provider feedback strategies can potentially reduce missed opportunities.…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated with Underimmunization at 3 Months of Age in Four Medically Underserved Areas

et al. 2004

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Objective. Risk factors for underimmunization at 3 months of age are not well described. This study examines coverage rates and factors associated with underimmunization at 3 months of age in four medically underserved areas.Methods. During 1997-1998, cross-sectional household surveys using a two-stage cluster sample design were conducted in four federally designated Health Professional Shortage Areas. Respondents were parents or caregivers of children ages 12-35 months: 847 from northern Manhattan, 843 from Detroit, 771 from San Diego, and 1,091 from rural Colorado. A child was considered up-to-date (UTD) with vaccinations at 3 months of age if documentation of receipt of diphtheria-tetanuspertussis, polio, haemophilus influenzae type B, and hepatitis B vaccines was obtained from a provider or a hand-held vaccination card, or both.Results. Household response rates ranged from 79% to 88% across sites. Vaccination coverage levels at 3 months of age varied across sites: 82.4% in northern Manhattan, 70.5% in Detroit, 82.3% in San Diego, and 75.8% in rural Colorado. Among children who were not UTD, the majority (65.7% to 71.5% per site) had missed vaccines due to missed opportunities. Factors associated with not being UTD varied by site and included having public or no insurance, Ն2 children living in the household, and the adult respondent being unmarried. At all sites, vaccination coverage among WIC enrollees was higher than coverage among children eligible for but not enrolled in WIC, but the association between UTD status and WIC enrollment was statistically significant for only one site and marginally significant for two other sites.Conclusions. Missed opportunities were a significant barrier to vaccinations, even at this early age. Practice-based strategies to reduce missed opportunities and prenatal WIC enrollment should be focused especially toward those at highest risk of underimmunization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors Associated with Underimmunization at 3 Months of Age in Four Medically Underserved Areas

et al. 2004

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“…2,3 Approximately 1 in 4 children aged 19 to 35 months has missed at least 1 recommended vaccine. 2 Reminder and recall messages sent by mail or telephone have been found effective at increasing childhood immunization coverage rates in many settings, 4,5 including private practices, 4 academic centers, 6,7 health maintenance organizations, 8,9 and public health clinics. 10 -13 On the basis of this evidence, the Task Force on Community Preventive Services in 1999 strongly recommended that all practices implement these approaches.…”

Section: Espite Increases In Immunization Coveragementioning

confidence: 99%

Adoption of Reminder and Recall Messages for Immunizations by Pediatricians and Public Health Clinics

Tierney¹,

Yusuf

McMahon

et al. 2003

Pediatrics

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ABSTRACT. Objective. Strong scientific evidence and national recommendations support the use of reminder and recall messages to improve immunization coverage rates, yet reports have suggested that only a minority of pediatric practices use such messages. Our aims were to 1) determine the proportions of pediatric practices and public clinics that currently use practicebased reminder or recall messages and routinely undergo immunization assessment efforts, 2) evaluate barriers and supports to implementing these practices, and 3) identify predictors of either current use or plans for future adoption of these practices.Methods. This study combined qualitative and quantitative methods in sequential phases. In the qualitative phase, we conducted semistructured, open-ended interviews with a convenience sample of 18 clinician-administrators representing adopters and nonadopters of these messages in both private practices and public health clinics. In the subsequent quantitative phase, we mailed a structured, closed-ended survey to national samples of randomly selected pediatricians (n ‫؍‬ 600) and public clinics (n ‫؍‬ 600).Results. Response rates were 75% for pediatricians and 77% for public clinics. Among pediatricians, 38% were conducting regular assessments of immunization coverage but only 16% were currently using routine reminder or recall messages. Among public clinics, 85% were conducting regular assessments and 51% were using reminder or recall messages. Among pediatricians' practices, the most commonly reported barriers to the adoption of reminder or recall messages were lack of time and funding and the inability to identify children at specified ages. For pediatricians' practices, the strongest predictors of current use of reminder or recall messages were having a champion who led efforts to improve immunization delivery (odds ratio: 1.85; 95% confidence interval: 1.08 -3.18) and current use of regular immunization assessments (odds ratio: 2.30; 95% confidence interval: 1.33-3.84). Likewise, for public health clinics, having a champion to lead immunization improvement efforts and believing that their current system needed improvement was associated with current use of reminder or recall messages.Conclusions. Reminder and recall messages remain underused by both pediatricians and public health clinics. Promising strategies to promote adoption of these approaches in both the private and the public sectors include identifying and training champions to promote immunization delivery improvement efforts and helping practices develop methods to identify children at specific ages. Pediatrics 2003;112:1076 -1082; immunizations, interventions, quality of care, recall, reminder, assessment.ABBREVIATIONS. OR, odds ratio; CI, confidence interval.

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“…15 In 1999, the Task Force on Community Preventive Services reviewed studies on the effectiveness of schoolentry laws and found 6 regional studies of school-entry laws for young children that were associated with reductions in disease rates and outbreaks and 3 national studies that showed that states with school-entry laws had lower incidence rates for mumps and measles than states without such laws. 7,8 These effects were particularly strong where the laws were enforced by excluding unvaccinated, nonexempt children from school. Studies have shown the effectiveness of school-entry laws in hastening the implementation of new recommendations that impact adolescents, as well as vaccine coverage for MMR and Td.…”

Section: Legal and Philosophical Rationales For School-entry Laws In mentioning

confidence: 99%

Delivering New Vaccines to Adolescents: The Role of School-Entry Laws

et al. 2008

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In the United States, state-based school-entry vaccination laws have been used effectively to rapidly increase vaccination rates among adolescents, in particular, for hepatitis B vaccine. New vaccines for adolescents raise the question of whether and under what circumstances school-entry laws may be used to increase coverage rates with these vaccines. The new vaccines differ somewhat from their predecessors and raise policy and legal issues. For example, some of the new vaccines prevent diseases for which the primary mode of transmission is sexual contact. Mandating these vaccines before school entry has been met with concern by those who believe that mandates for this type of vaccine not only intrude on parental decision-making rights but might also lead to sexual promiscuity among youth. In this article we explore (1) the possible utility of school-entry requirements to increase the delivery of the new vaccines for adolescents, including the legal basis for US school-entry laws, (2) arguments in favor and concerns about the adoption of laws for adolescent vaccination, and (3) the importance of including diverse stakeholders in the deliberative process and formulating and implementing laws in a way that maximizes their acceptance and effectiveness.

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Improving Immunization Coverage Rates: An Evidence-based Review of the Literature

Cited by 159 publications

References 160 publications

Factors Associated with Underimmunization at 3 Months of Age in Four Medically Underserved Areas

Factors Associated with Underimmunization at 3 Months of Age in Four Medically Underserved Areas

Adoption of Reminder and Recall Messages for Immunizations by Pediatricians and Public Health Clinics

Delivering New Vaccines to Adolescents: The Role of School-Entry Laws

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