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Published on: June 11, 2012
A comparison of populations vaccinated in a public service and in a private hospital setting in the same area
Elisabetta Pandolfi1, Maria C Graziani, Roberto Ieraci
1Bambino Gesù Pediatric Hospital, Rome, Italy. pandolfi.elisabetta@gmail.com
Insights
Hospital-based immunisation services attract more high-risk children, including those with underlying conditions and low birthweight. Integrating public and hospital practices can improve vaccination rates for these vulnerable groups.
Area of Science:
- Pediatrics
- Public Health
- Vaccinology
Background:
- Achieving optimal immunisation rates in pediatric risk groups is a key public health challenge.
- Children with chronic conditions often present difficulties in vaccination uptake.
- Vaccine provider type may influence the engagement of high-risk children.
Purpose of the Study:
- To compare the characteristics of children attending private hospital versus public immunisation services.
- To assess differences in the prevalence of underlying diseases between provider types.
- To investigate whether provider choice impacts immunisation timeliness.
Main Methods:
- Cross-sectional study involving parents of children aged 2-36 months in Rome, Italy.
- Face-to-face interviews collected data on child characteristics and immunisation history.
- Logistic regression analysed timeliness and its determinants.
Main Results:
- Hospital-vaccinated children were more likely to be firstborn, female, longer breastfed, with lower birthweight, and prior hospitalisation.
- High-risk children constituted 9.2% of the hospital group versus 0% of the public group (P=0.001).
- Despite higher immunisation delays in the hospital setting, multivariate analysis showed no significant difference in timeliness between public and private providers.
Conclusions:
- Hospital settings appear to attract a higher proportion of high-risk children, including those with underlying conditions and low birthweight.
- Integrating public and hospital vaccination services and enhancing parent communication could boost immunisation rates in at-risk populations.
- Such integration may also help prevent vaccination delays, benefiting both high-risk and general pediatric populations.
Background:
Improving immunisation rates in risk groups is one of the main objectives in vaccination strategies. However, achieving high vaccination rates in children with chronic conditions is difficult. Different types of vaccine providers may differently attract high risk children.
Aim:
To describe the characteristics of two populations of children who attended a private and a public immunisation provider in the same area. Secondarily, to determine if prevalence of patients with underlying diseases by type of provider differs and to study if the choice of different providers influences timeliness in immunisation.
Methods:
We performed a cross-sectional study on parents of children 2-36 months of age who attended a private hospital immunisation service or a public immunisation office serving the same metropolitan area of Rome, Italy. Data on personal characteristics and immunisation history were collected through a face to face interview with parents of vaccinees, and compared by type of provider. Prevalence of underlying conditions was compared in the two populations. Timeliness in immunisation and its determinants were analysed through a logistic regression model.
Results:
A total of 202 parents of children 2-36 months of age were interviewed; 104 were in the public office, and 98 in the hospital practice. Children immunised in the hospital were more frequently firstborn female children, breast fed for a longer period, with a lower birthweight, and more frequently with a previous hospitalisation. The prevalence of high risk children immunised in the hospital was 9.2 vs 0% in the public service (P = 0.001). Immunisation delay for due vaccines was higher in the hospital practice than in the public service (DTP, polio, HBV, and Hib: 39.8% vs 22.1%; P = 0.005). Anyway multivariate analyses did not reveal differences in timeliness between the public and private hospital settings.
Conclusion:
Children with underlying diseases or a low birthweight were more frequently immunised in the hospital. This finding suggests that offering immunisations in a hospital setting may facilitate vaccination uptake in high risk groups. An integration between public and hospital practices and an effort to improve communication on vaccines to parents, may significantly increase immunisation rates in high risk groups and in the general population, and prevent immunisation delays.
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