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Measles vaccination in pediatric emergency departments during a measles outbreak
M L Lindegren1, W L Atkinson, K M Farizo
1Division of Immunization, National Center for Prevention Services, Centers for Disease Control and Prevention, Atlanta, GA 30333.
Insights
Many preschool-aged children visiting urban emergency departments were eligible for measles vaccination but were not vaccinated. Implementing optimal vaccination programs in emergency departments can improve measles immunization coverage for inner-city children.
Area of Science:
- Pediatric Emergency Medicine
- Vaccinology
- Public Health
Background:
- Measles outbreaks highlight the need for high vaccination coverage.
- Inner-city children may have limited access to routine healthcare, increasing reliance on emergency departments (EDs).
- Pediatric EDs present an opportunity to vaccinate children during community measles outbreaks.
Purpose of the Study:
- To determine the proportion of preschool-aged children in urban EDs eligible for measles vaccination.
- To describe the characteristics of vaccine-eligible children.
- To assess the effectiveness of ED immunization programs during a measles outbreak.
Main Methods:
- Cross-sectional study conducted in pediatric EDs of two urban hospitals in Chicago in 1989.
- Included children aged 6 months to 5 years attending the EDs.
- Assessed measles vaccination eligibility and vaccination status within the ED.
Main Results:
- 18% and 29% of preschool-aged patients in two EDs were eligible for measles vaccination.
- Common diagnoses for eligible children included viral syndrome, otitis media, and minor trauma.
- 59% of eligible children did not receive the measles vaccine in the ED; those with infectious/respiratory diagnoses were less likely to be vaccinated.
Conclusions:
- A significant proportion of eligible children visiting urban pediatric EDs were unvaccinated against measles.
- Pediatric EDs can serve as a crucial site for measles vaccination during outbreaks.
- Optimizing ED immunization programs can improve vaccination rates among underserved inner-city children.
Objective:
To determine the proportion of preschool-aged patients attending two inner-city hospital pediatric emergency departments (EDs) who were eligible for measles vaccination, to describe their demographic and clinical characteristics, and to assess the performance of the ED immunization programs that were implemented during a measles outbreak in vaccinating eligible children.
Design:
Cross-sectional study.
Setting:
Pediatric EDs of two urban hospitals in Chicago, Ill, in 1989.
Participants:
Children 6 months to 5 years of age seen in the EDs.
Intervention:
None.
Main Outcome Measures:
The proportion of preschool-aged patients attending the two EDs who were eligible for measles vaccination and the proportion of vaccine-eligible children who were given measles vaccine.
Results:
Of 508 ED patients at hospital A and 255 patients at hospital B, 18% and 29%, respectively, were considered to be vaccine eligible. The most common discharge diagnoses of eligible patients were viral syndrome, otitis media, and minor trauma. Of vaccine-eligible patients, 59% at hospitals A and B were not vaccinated in the ED. At hospital B, patients with an infectious or respiratory disease diagnosis were less likely to be vaccinated than those with other diagnoses (P < .05).
Conclusions:
Many children seen in these EDs were eligible for measles vaccination, and many eligible patients were not vaccinated. During community outbreaks of measles, optimal vaccination programs in pediatric EDs could increase vaccination coverage among inner-city preschool-aged children who may have limited access to health care.