Western States Medical Monographs. Effective Vaccine Delivery Programs to Improve Local Immunization Rates: A Review of the Literature and Recommendations.

摘要

Vaccine-preventable diseases in Colorado have reappeared after 2012 since being eliminated as late as the year 2000. Immunization rates have decreased to as low as 75% and exemptions have continued to rise, as high as 4.6%. Research has identified that barriers to vaccination include both high and low income, high and low levels of education, perceived costs, vaccine schedule and perceived risk of vaccine safety. Much of this research was reviewed by Peter Briss, et al in 2000 (Peter A. Briss, 2000). Vaccination promoters include encouragement from coworkers or peers and belief that vaccines are the norm. Effective programs for improving vaccination rates include those designed to increase community demand, enhance access, or facilitate provider-based interventions. When combined with other interventions, client reminder/recall programs increased immunization rates up to 16%. Instituting vaccine requirements for childcare, school or college enrollment improved immunization rates and lowered disease rates. Exemptors in Colorado alone are 22 times more likely to contract measles and 5.9 times more likely to contract pertussis than vaccinated children. Reducing out-of-pocket costs has increased immunization rates by 10% and expanding access in health care settings such as drop-in or walk-in clinics for vaccines has increased immunization rates by 10% in other studies. Vaccinations in non-medical settings such as Women, Infants, and Children (WIC) clinics have shown up to a 34% increase in immunization rates. Automated messages or 'pop-up' on electronic medical records have led to 17% increase in immunization rates.