Reminder-Recall Program Improves Immunization Rates

Vaccination rates among underserved populations can be improved with a program that provides close individual follow-up. A project led by Surabhi Vora, MD, MPH, Pediatric Immunization Program (PIP) Staff, Department of Pediatric Infectious Diseases, University of Chicago, set out to achieve at least 90% on-time adherence to AAP/ACIP immunization recommendations for parts of Chicago's inner-city. Of the 188 children enrolled to date, about 90% are up-to-date with immunizations based on AAP/ACIP guidelines. "This compares with a rate of 69.1% for the City of Chicago, as established by the 2002 NIS for 19-35 month olds, and 56% for African-American children at 13 months of age," said Dr. Vora.

The program uses the reminder-recall "on foot" strategy. The study enrolled English-speaking parents of healthy full-term newborns living within a predefined set of zip codes accessible by PIP workers. Parents were educated about immunization and a preferred method of contact was agreed upon. The PIP staff would phone the parents before their clinic appointments. PIP outreach workers would also go to the clinic appointments, both to develop a relationship with the parent and to see if parents showed up.

"If we can't reach [parents] or if they don't show up, then we go to their homes," explained Dr. Vora. If the parents can't be found at home, then the workers "call them and mail letters," said Dr. Vora, who described the outreach workers as persistent.

The major drawbacks of the program, according to Dr. Vora, are the expense of workers tracking down parents, and patients moving out of the area or simply losing all contact with PIP. She noted, however, that "there are a lot of avenues through which [this program] could be implemented if we could show that this type of program works." (Poster Session 5480)