According to a new study led by researchers at Columbia University Medical Center and NewYork-Presbyterian Hospital, there are several factors that contribute to children missing immunization visits.
"We know that approximately 20 percent of our nation's young children are under-immunized, and previous research has identified many sociodemographic factors, such as lacking insurance or a usual source of care, that may lead to under-immunization. What we wanted to look at were families who actually had a place to go - their child has a health care provider - but they missed one or more immunization appointments," said the lead investigator, Melissa Stockwell, M.D., M.P.H., assistant professor of clinical pediatrics and population family health at Columbia University's College of Physicians & Surgeons and Mailman School of Public Health, medical director of the NewYork-Presbyterian Hospital Immunization Registry (EzVAC) and a pediatrician at NewYork-Presbyterian Morgan Stanley Children's Hospital.
"What we have identified are small steps that health care providers can take to improve keeping immunization appointments - such as talking with parents about the importance of immunizations, having open lines of communication with them, and making it easier for parents to schedule/reschedule appointments. We believe that the first step is making providers aware that how their clinic or office is set up can affect compliance with appointments - such as how long it takes to make an appointment or how rescheduling requests are processed," added Dr. Stockwell.
Dr. Stockwell and her research team surveyed the parents of 705 children under the age of three about immunization experiences. The interviews (conducted in both English and Spanish) took place at community health centers, hospital-based clinics, private practices, and community-based organizations in the Washington Heights, Harlem, Bronx, Upper East Side, and Upper West Side areas of New York City.
Parents who had to reschedule an appointment were found to be nearly four times as likely to miss their child's immunization appointment; those who had problems scheduling an appointment were also more likely to miss an appointment. Doubting the importance of vaccines made a parent more than three times as likely to miss appointments. Parents who reported difficulty communicating with their child's healthcare provider were nearly three times as likely to miss their child's scheduled immunization appointment.
A significant association was found between missed visits and under-immunization. Children whose parents reported missing an immunization visit were 2.5 times more likely to have been under-immunized (confirmed by parent-held immunization records, medical record or immunization registry).