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Improving Immunization Rates During the 2019 Measles Outbreak
Steven Louis Rosas1, Henry J Simpson1, Christopher Martinez1
1Mayo Clinic Health System Red Cedar-Family Medicine, Menomonie, WI, USA.
Insights
Provider letters encouraging measles immunization increased vaccination rates in some pediatric patients. However, this intervention did not sway parents with pre-existing anti-vaccination sentiments.
Area of Science:
- Pediatrics
- Public Health
- Immunization
Background:
- Measles outbreaks in the US in 2019 raised public health concerns.
- Pediatric immunization rates are crucial for community health.
- Low vaccination rates can lead to outbreaks of preventable diseases.
Purpose of the Study:
- To assess the effectiveness of a provider-led intervention to increase measles immunization rates in pediatric patients.
- To evaluate the impact of personalized communication on parental vaccination decisions.
Main Methods:
- Identified under-immunized pediatric patients using electronic medical records (EMR).
- Reviewed and updated patient charts for immunization accuracy.
- Sent personalized letters from primary care providers and CDC measles fact sheets to parents of unvaccinated children.
Main Results:
- Out of 44 patients whose parents received the mailing, 5 children received the measles, mumps, and rubella (MMR) vaccine.
- Among the 20 patients whose parents had previously documented intent to not vaccinate, none received the MMR vaccine.
- The intervention showed a modest increase in MMR immunization rates for some children.
Conclusions:
- Personalized provider guidance can encourage measles immunization among hesitant parents.
- Provider advice was ineffective in changing the minds of parents firmly against vaccination.
- Targeted communication strategies are important, but may not overcome deeply held anti-vaccination beliefs.
Abstract:
In 2019, there were multiple outbreaks of measles in the United States. In the context of the public awareness of these outbreaks, we performed an intervention with the intent to improve the rate of measles immunization in our pediatric population. Pediatric patients that were lacking adequate measles immunization were identified by electronic medical record (EMR) survey. Charts were reviewed and updated if records were found to be incomplete. Parents of the remaining children were sent a letter, personally signed by the child's primary care provider, encouraging measles immunization. A measles fact sheet, produced by the United States Center for Disease Control, was also included with the letter. There were 44 patients in the study group whose parents received a letter and measles fact sheet. As a result, 5 of these children were brought in for a measles, mumps, and rubella (MMR) immunization. The 44 patients whose parents received a letter included 20 patients whose parents had previously expressed intent to not vaccinate their children as documented in the EMR. None of these children received an MMR immunization. Although small in scope, this project provides a glimpse into the importance of personal provider guidance to parents who are inclined to immunize their children. Unfortunately, it also demonstrated that provider advice did not change the opinions of parents who had already taken a stance against vaccination, even in the context of an urgent public health situation that had garnered widespread coverage in the lay press and social media.
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