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Frequency and erroneous usage of temporary medical exemptions and knowledge of immunization guidelines among some

Alazandria R Cruze1, Guoyan Zhang1, Lakisha Thomas1

  • 1Florida Department of Health in Miami-Dade County, Epidemiology, Disease Control and Immunization Services, Florida Department of Health in Miami-Dade County, 8600 NW 17th St. Suite 200, Miami, FL 33126, USA.

Vaccine
|June 25, 2014
PubMed
Abstract

Insights

Healthcare providers showed poor knowledge of immunization guidelines, leading to incorrect medical exemptions. Education and improved vaccine certificate information are crucial to reduce errors and ensure child vaccination compliance.

Area of Science:

  • Public Health
  • Immunization Practices
  • Pediatric Medicine

Background:

  • Increasing rates of erroneously issued temporary medical exemptions (TME) were observed.
  • This trend impacts adherence to immunization guidelines and vaccine certificate requirements.

Purpose of the Study:

  • To assess healthcare provider knowledge and practices concerning immunization guidelines and the Florida Certificate of Immunization (DH-680).
  • To identify the root causes of increased TME issuance in Miami-Dade County, Florida.

Main Methods:

  • Physicians improperly issuing 3+ TMEs were identified through immunization certificate review.
  • Face-to-face interviews and educational interventions were conducted with 134 providers.
  • Data analysis utilized SAS 9.2.

Main Results:

  • Only 3.85% of providers answered all vaccine knowledge questions correctly.
  • Significant knowledge gaps existed regarding varicella vaccine doses and TME issuance criteria.
  • 54.8% of providers missed questions on the proper TME scenario.

Conclusions:

  • Targeted educational materials and training are necessary for the medical community to eliminate improper TME use.
  • Enhanced, multilingual explanations on the Florida Immunization Certificate are recommended.
  • Surveillance and education initiatives reduced TMEs by 12% (kindergarten) and 4.9% (seventh grade).
Keywords:
KnowledgePediatriciansPracticeSchool healthSchool immunizationsTemporary medical exemptions

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