An Easy Way to Improve Immunization Rates: Turn Patients Into Record Holders

The importance of vaccination has been well proved over the years for both individuals and the community as a whole. According to the 2004 to 2006 National Immunization Survey sponsored by the CDC, about 80% of children in the United States are up-to-date (UTD) with their immunizations, a rate that although respectable still leaves room for improvement.¹

A recent study by McElligott and Darden¹ indicates that patient-held vaccination records can potentially improve immunization rates. To determine whether patient-held records correlate with immunization rates, McElligott and Darden analyzed data from the National Immunization Survey.

This telephone survey included households with children aged 19 to 35 months. During the telephone interview, demographic and vaccination information were collected for all children in the house. The survey asked parents if they had a patient-held vaccination record available for the child in question. Additional information, such as race, maternal education, number of children in the home, poverty status, number of providers who gave the child vaccines, and language spoken, was also collected. Immunization data were gathered directly from the vaccine providers for those children. The authors used the vaccine provider’s records for UTD status; however, they excluded pneumococcal conjugate vaccine, influenza vaccine, and varicella-zoster vaccine from their analysis.

Vaccination rates improved when patients held records. The authors found that 40.8% of parents had their child’s vaccination record available. With all variables controlled for, children whose parents had the record available were 62% more likely to be UTD in their immunizations. Vaccination status fluctuated by all of the variables collected; however, presence of a record correlated with increased immunization for each variable.

Some of the greatest differences appeared to be in groups at highest risk for incomplete immunization status, such as those with multiple health care providers or low maternal education. Improved vaccination status with the presence of a patient-held record could be the result of many factors. These may include increased parental awareness of immunizations and improved communication among multiple providers. For patients who have their vaccination records, any visit (sick visits or trips to the emergency department) could be an opportunity to update their vaccine status.

McElligott and Darden state that their study was limited because of the difficulty in determining whether the improvement in immunization status was a result of record possession or whether both the improved immunization status and the record possession are related to a third factor, such as organizational skills. Another limitation was that the National Immunization Survey did not ask whether records were previously provided and lost or whether they were not provided by the practice used. In addition, the survey did not assess the accuracy of the records held by parents. Despite these limitations, the McElligott and Darden study highlights an easy-to-implement method that could significantly improve immunization rates.

Patient-held records also stress importance of vaccination. Practitioners can use the patient-held records to emphasize the importance of vaccination in several ways. They can ask to see the vaccination record at each visit, review the immunization status with the family, update the record as needed, and remind the family to bring the record for visits with other health care providers and for trips to the emergency department.

References:

Reference:

1.

McElligott JT, Darden PM. Are patient-held vaccination records associatedwith improved vaccination coverage rates?

Pediatrics

. 2010;125:e467-e472.