Related Experiment Video
Updated: Jun 22, 2026
Fabrication of Pulsatile Polymeric Microparticles Encapsulating Rabies Antigen
Published on: May 12, 2023
Seize the moments: missed opportunities to immunize at the family practice level
Nikki Turner1, Cameron Grant, Felicity Goodyear-Smith
1Immunisation Advisory Centre, Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand. n.turner@auckland.ac.nz
Insights
Missed immunization opportunities (MOs) are common in primary care, impacting childhood vaccination. Reducing MOs is crucial for improving immunization coverage and preventing under-immunization in children.
Area of Science:
- Pediatrics
- Public Health
- Primary Care Medicine
Background:
- Missed immunization opportunities (MOs) represent a significant challenge to achieving high vaccination coverage rates.
- Addressing MOs is essential for effective public health strategies in child immunization.
Purpose of the Study:
- To investigate the prevalence and characteristics of MOs within New Zealand's primary care settings.
- To determine the impact of MOs on the completeness of childhood immunizations.
Main Methods:
- A retrospective audit was conducted on the medical records of children under two years old.
- Data were collected from 62 primary care practices in Auckland, New Zealand, involving approximately 10 children per practice.
- A total of 616 children and 10,094 practice visits were analyzed.
Main Results:
- Missed immunization opportunities (MOs) were identified in 5.5% of all visits across 97% of audited practices.
- Children with at least one MO visit were 3.1 times more likely to have incomplete immunizations.
- A higher percentage of MO visits correlated with a significantly increased risk of under-immunization, up to ninefold.
Conclusions:
- Missed immunization opportunities are prevalent in primary care, affecting nearly one-third of child visits.
- The likelihood of incomplete immunization escalates with the frequency of MOs.
- Comprehensive strategies targeting practitioners and healthcare systems are necessary to minimize MOs and improve vaccination rates.
Background:
Missed immunization opportunities (MOs) are a significant barrier to achieving high immunization coverage.
Objective:
To describe the nature of MOs to immunize within primary care in New Zealand and their effect on immunization completeness.
Methods:
Audit of medical records of approximately 10 randomly selected children <2 years old from each of 62 primary care practices in Auckland, New Zealand.
Results:
The 616 audited children made 10 094 visits to primary care practices. MOs occurred at 97% (60) of practices, in 556 (5.5%) of visits, and 31% of the children had one or more visits that were an MO. Overall, children who had any recorded MO visit were 3.1 times more likely to be incompletely immunized than children who had no recorded MO (95% CI 1.87-5.14). Children with the greater percentage of overall visits that were MOs had up to a 9 times increased likelihood of incomplete immunization compared to those who had no MO visits. Nurse visits have less MOs than doctor (1.5% versus 6%) but are more likely to occur within well-child visits.
Conclusions:
MOs are common in primary care practices, occurring in nearly one-third of visiting children. The risk of under-immunization increases with the increasing percentage of visits that are MOs. Overall strategies directed at reducing MOs need to focus on a range of aspects for the practitioner and the practice system.
Related Concept Videos
01:30Preventive Healthcare Services
01:24Smallpox
01:51Vaccinations
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...