OBJECTIVES: To assess the frequency and characteristics of missed opportunities for influenza immunization in children with chronic medical conditions and, among unimmunized children in that group, to explore parent-reported reasons for not vaccinating their child. DESIGN: Prospective cohort study. Data were obtained from billing and immunization registry databases and telephone interviews of parents. SETTING: Four pediatric practices in metropolitan Denver, Colo, during the 2002-2003 influenza season. PARTICIPANTS: Children aged 6 to 72 months with 1 or more chronic medical conditions. Main Outcome Measure A missed opportunity for influenza immunization, defined as having a billed encounter, being eligible for immunization, and not receiving vaccine. Subjects with asthma were analyzed separately from those with other conditions. RESULTS: We identified 926 children with chronic conditions: 820 (89%) with asthma only and 106 (11%) with other conditions. Missed opportunities occurred at 78% of all vaccine-eligible visits for children with asthma and 74% of all visits for children with other conditions. For children with asthma, 92% of vaccine-eligible visits in December and January resulted in a missed opportunity vs 69% in October and November; for children with other conditions, corresponding frequencies were 86% vs 68%, respectively. For children with asthma, 86% of non-well-child visits resulted in a missed opportunity, compared with 62% of well-child visits; similar frequencies were seen among children with other chronic conditions. Parents of unimmunized children reported lack of a physician recommendation and low perceived susceptibility to influenza as the primary reasons for not immunizing their child. CONCLUSION: Missed opportunities contribute significantly to low influenza immunization rates among children with chronic medical conditions.
OBJECTIVES: To assess the frequency and characteristics of missed opportunities for influenza immunization in children with chronic medical conditions and, among unimmunized children in that group, to explore parent-reported reasons for not vaccinating their child. DESIGN: Prospective cohort study. Data were obtained from billing and immunization registry databases and telephone interviews of parents. SETTING: Four pediatric practices in metropolitan Denver, Colo, during the 2002-2003 influenza season. PARTICIPANTS: Children aged 6 to 72 months with 1 or more chronic medical conditions. Main Outcome Measure A missed opportunity for influenza immunization, defined as having a billed encounter, being eligible for immunization, and not receiving vaccine. Subjects with asthma were analyzed separately from those with other conditions. RESULTS: We identified 926 children with chronic conditions: 820 (89%) with asthma only and 106 (11%) with other conditions. Missed opportunities occurred at 78% of all vaccine-eligible visits for children with asthma and 74% of all visits for children with other conditions. For children with asthma, 92% of vaccine-eligible visits in December and January resulted in a missed opportunity vs 69% in October and November; for children with other conditions, corresponding frequencies were 86% vs 68%, respectively. For children with asthma, 86% of non-well-child visits resulted in a missed opportunity, compared with 62% of well-child visits; similar frequencies were seen among children with other chronic conditions. Parents of unimmunized children reported lack of a physician recommendation and low perceived susceptibility to influenza as the primary reasons for not immunizing their child. CONCLUSION: Missed opportunities contribute significantly to low influenza immunization rates among children with chronic medical conditions.
Authors: Karen Pazol; Julie A Gazmararian; Mila M Prill; Emily M O'Malley; Deborah Jelks; Margaret S Coleman; Alan R Hinman; Walter A Orenstein Journal: Open Health Serv Policy J Date: 2008-01-01
Authors: Chyongchiou J Lin; Mary Patricia Nowalk; Richard K Zimmerman; Feng-Shou Ko; Lisa Zoffel; Alejandro Hoberman; Diana H Kearney Journal: J Urban Health Date: 2006-09 Impact factor: 3.671
Authors: Norma J Allred; Katherine A Poehling; Peter G Szilagyi; Fan Zhang; Kathryn M Edwards; Mary Allen Staat; Stephanie Donauer; Mila M Prill; Gerry Fairbrother Journal: J Public Health Manag Pract Date: 2011 Nov-Dec