Scheduling problems lead to missed immunizations

By Anne Harding

NEW YORK (Reuters Health) - Making sure kids get all their shots has a lot to do with convenience and communication, new research shows.

Children whose parents have difficulty scheduling appointments or who have a tough time communicating with their child's doctor are more likely to be under-immunized, Dr. Melissa Stockwell of Columbia University's College of Physicians & Surgeons and her colleagues found.

Stockwell reported these findings today at the Pediatric Academic Societies' annual meeting in Baltimore.

'Under-immunized' means the children were missing at least one of the shots making up the basic early childhood vaccination series given to children 19 to 35 months old, Stockwell explained in an interview. "Any time kids are under-immunized, it does put them at risk for vaccine-preventable diseases," she said.

While a good deal is known about why children with poor access to health care don't get immunizations, Stockwell and her colleagues wanted to find out why some families who do have access to care miss shots. They surveyed parents of 705 children younger than 3 years old at clinics, hospitals, physician offices and community organizations in New York City. Ninety-four percent had a regular doctor.

Children whose parents had rescheduled appointments were 3.8 times more likely to have missed an immunization visit, while those whose parents had doubts about the importance of vaccines were 3.3 times more likely to have missed an appointment.

Parents who had trouble scheduling appointments were three times as likely to miss one, while parents who said they didn't have a doctor who listened to them were 2.7 times more likely to miss an appointment.

On the other hand, parents who reported having families and friends who were "positive about immunizations" were much less likely to miss immunization appointments.

Global travel and outbreaks of vaccine-preventable diseases like whooping cough (pertussis) mean that parents can no longer rely on "herd immunity" to protect their children, Stockwell noted. "Unfortunately we can't really rely on saying 'we don't see these things around anymore'."

Doctors should do their best to make scheduling visits easy for parents, and be open to talking with them, the researcher added. "If there are parents who find themselves missing visits because they have doubts about immunization," she said, "they should go talk to their primary care provider. There's a lot of misinformation and fears and misconceptions out there."