Vaccination of hard‐to‐reach children

Abstract

The vaccination of children who have not been vaccinated in a timely manner has long been a concern for health professionals. These hard-to-reach children may come from myriad backgrounds and are not vaccinated for a range of reasons.1 Strategies need to be implemented to vaccinate this group.A study of the immunisation status of children aged less than seven years presenting to Wagga Wagga Base Hospital emergency department (ED) was conducted for presentations in July and December 2004 to identify if the immunisation rates of children presenting to the ED were an over-representation of unimmunised children when compared with the immunisation rate in the local community. Children presenting to the ED and those subsequently admitted to the children's ward would be a captive group to target for immunisation if needed.Children were grouped as being due for vaccination when they were due by age and were not more than four weeks past their due date. Children were grouped as overdue for vaccination when they were four or more weeks past the due date for one or more of their vaccinations.July and December had 425 and 384 presentations to the ED respectively. Duplicate presentations were removed, resulting in a total of 705 individual children presenting. Figure 1 shows the percentage of children who were either due or overdue for vaccination and if they had been subsequently vaccinated.Ninety-three children (13.2%) who presented to the ED were either due or overdue for vaccination. Fifty-six of these children went on to be vaccinated after their ED presentation.Of a total of 122 children who presented to the ED and were admitted to a hospital ward, 18 were due or overdue for vaccination. Of these, three were vaccinated at the hospital and nine have been vaccinated since hospital, leaving six admitted children not vaccinated post discharge.