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Providing immunizations in a pediatric emergency department: underimmunization rates and parental acceptance
1Department of Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Insights
Many children lack up-to-date vaccinations. Providing immunizations in emergency departments, especially when under-vaccination is documented, significantly increases vaccine acceptance rates.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Immunization Programs
Background:
- Many children present to healthcare settings with incomplete vaccination records.
- Assessing and addressing vaccination status in pediatric emergency departments is crucial for public health.
- Urban public hospitals serve diverse populations with varying access to routine healthcare.
Purpose of the Study:
- To evaluate vaccination coverage among children presenting to a pediatric emergency department.
- To administer age-appropriate immunizations to eligible children.
- To determine the impact of documented under-immunization on vaccine acceptance.
Main Methods:
- Intervention study conducted in a pediatric emergency department.
- Convenience sample of children aged 0-72 months.
- Immunization provided to eligible children during their visit.
Main Results:
- Over 9,000 children were enrolled; 59% were under-immunized.
- 2,514 children received 6,482 immunizations.
- Parents with documentation of under-vaccination were nearly 5 times more likely to accept immunizations (71% vs. 15%).
Conclusions:
- A significant proportion of children in the study were under-immunized.
- Documented under-vaccination strongly predicts parental acceptance of immunizations.
- Vaccinating in emergency departments is feasible and supports the need for accessible vaccine registries.
Objectives:
To assess the vaccination status and vaccinate eligible children with age-appropriate antigens.
Design:
Intervention.
Setting:
Pediatric emergency department in an urban, public hospital.
Patients:
Convenience sample of children, aged birth through 72 months.
Interventions:
Immunization of eligible children.
Main Outcome Measures:
1) Immunization coverage rates in the sample population, 2) Acceptance rates of immunization.
Results:
A total of 9321 children were enrolled over a 2-year period. Fifty-nine percent were documented to be underimmunized. Overall, 2514 children received a total of 6482 immunizations. Parents who carried portable immunization cards documenting that their child was underimmunized were almost five times more likely to accept immunization for their child than parents who lacked documentation (71% vs 15%, P < 0.0001). The estimated cost of providing immunizations in the emergency department was $47.15 per child immunized, or $18.56 per immunization given.
Conclusions:
The majority of children with documentation of immunization status were underimmunized. When documentation of underimmunization was available, parents were significantly more likely to accept vaccination. These data suggest that vaccinating children in nontraditional settings is feasible and support the creation of an accessible vaccine registry.