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Parent reports on willingness to accept childhood immunizations during urgent care visits
S L Udovic1, T A Lieu, S B Black
1Joint Medical Program, University of California, Berkeley and San Francisco, California, USA.
Insights
Most parents of underimmunized toddlers are willing to accept childhood immunizations during urgent care visits if recommended by a clinician. This highlights a potential strategy to improve vaccination rates in young children.
Area of Science:
- Pediatric Health
- Public Health
- Vaccination Programs
Background:
- Underimmunization remains a significant public health concern, impacting childhood disease prevention.
- Urgent care visits present an opportunistic setting for addressing missed childhood immunizations.
- Understanding parental willingness is crucial for implementing vaccination services in non-traditional settings.
Purpose of the Study:
- To determine parental acceptance of childhood immunizations during urgent care visits.
- To identify key factors predicting parents' willingness to vaccinate during urgent care encounters.
Main Methods:
- A cross-sectional telephone survey was conducted with parents of underimmunized children (18-24 months).
- Participants were recruited from a health maintenance organization following an urgent care visit.
- Chart reviews confirmed immunization status and identified contraindications to vaccination.
Main Results:
- 86% of parents expressed willingness to accept childhood immunizations during the urgent care visit.
- Key predictors of willingness included unawareness of underimmunization, lower perceived child sickness, reduced concern about vaccine risks, and nonwhite race.
- Parental income and education levels were not significant predictors of vaccination acceptance.
Conclusions:
- A majority of parents are receptive to childhood immunizations at urgent care visits when recommended by clinicians.
- Implementing systems to alert urgent care providers about due immunizations can improve vaccination coverage.
- Urgent care settings offer a promising avenue for enhancing childhood immunization rates.
Objectives:
To 1) describe whether parents would be willing to accept childhood immunizations at urgent care visits; and 2) identify predictors of parents' willingness to accept childhood immunizations at urgent care visits.
Design And Participants:
Cross-sectional telephone survey of parents of children aged 18 to 24 months who were underimmunized according to a computerized immunization tracking system and who had recently made an urgent care visit in a regional group-model health maintenance organization in Northern California. Chart review was conducted to confirm immunization status and to identify contraindications to vaccination.
Results:
Of the 424 eligible participants, 351 (83%) completed interviews. Children with contraindications to vaccination and children who were actually up-to-date at the time of the urgent care visit were excluded, leaving 263 families in the final analysis. Among these parents, 75% said they would have been willing to have their child immunized at the urgent care visit in question if the physician had suggested it. An additional 11% said they would have accepted vaccination if the physician told them that the shot would be safe and strongly encouraged them to accept it. Overall, 86% reported they theoretically would have accepted an immunization during the urgent care visit. In the multivariate analysis, the strongest predictors of stated willingness to accept shots at the urgent care visit were the parent: 1) not being aware that their child was underimmunized (odds ratio [OR] 3.5, 95% confidence interval [CI], 1.6-7.7); 2) perceiving that the child was not very sick at the visit (OR 1.8, 95% CI, 1.1-3.0); 3) being less concerned about the risk of shots (OR 1.8, 95% CI, 1.2-2.5); and 4) being of nonwhite race (OR 3.6, 95% CI, 1.6-7.7). Income and education were not significantly associated with reported willingness to accept immunization.
Conclusions:
We conclude that most parents of underimmunized toddlers report being willing to accept immunizations during urgent care visits if the clinician recommends it. More effective ways of alerting providers in urgent care settings when immunizations are due, such as indications on a chart or registration form, hold promise for improving immunization coverage rates.