The importance of immunizations
Vaccinations are one of the great public health achievements
in the United States in the last century. Smallpox and polio are
virtually eradicated, and the incidence of more than half a dozen
other diseases (e.g., Haemophilus influenza B (Hib), measles,
mumps, rubella, diphtheria and tetanus) has been significantly
reduced. Unfortunately, some of these diseases are still widespread
in the world, and are even diagnosed from time to time in the
United States. Despite efforts to provide vaccines to all children
who need them, many do not receive some or all of the recommended
immunizations, causing them to suffer severe illness and even
death from diseases that can be prevented.
Although achieving and maintaining high vaccine coverage levels
is a priority in pediatric health, opportunities to immunize are
sometimes missed due to a lack of simultaneous administration
of vaccines, being unaware that a child needs vaccines, invalid
contraindications, or avoidance of administering an accelerated
vaccination schedule when a child is behind schedule for receiving
vaccinations.
Effective interventions to improve immunization rates include:
clinician recommendation, which has the greatest impact on patient/family
behavior; using all visits to check immunization records to make
sure the child is on schedule; reminder/recall systems, including
postcards, letters and calls; and patient/parent education.
Parent education can be particularly important due to speculation
and misinformation linking immunizations to certain adverse conditions
like asthma and autism. To ease parents' fears and lessen their
resistance to immunizations, take time during office visits to
acknowledge fears and answer questions, provide personal reassurance,
help parents weigh the benefits and risks—both to their
child and to the community—of immunizations, discuss research
findings and resources about the safety of vaccines, and follow
up with your recommendations at the next appointment.
