Seize the moments: missed opportunities to immunize at the family practice level
Open Access
- 28 May 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in Family Practice
- Vol. 26 (4) , 275-278
- https://doi.org/10.1093/fampra/cmp028
Abstract
Background. Missed immunization opportunities (MOs) are a significant barrier to achieving high immunization coverage. Objective. To describe the nature of MOs to immunize within primary care in New Zealand and their effect on immunization completeness. Methods. Audit of medical records of ∼10 randomly selected children Results. The 616 audited children made 10 094 visits to primary care practices. MOs occurred at 97% (60) of practices, in 556 (5.5%) of visits, and 31% of the children had one or more visits that were an MO. Overall, children who had any recorded MO visit were 3.1 times more likely to be incompletely immunized than children who had no recorded MO (95% CI 1.87–5.14). Children with the greater percentage of overall visits that were MOs had up to a 9 times increased likelihood of incomplete immunization compared to those who had no MO visits. Nurse visits have less MOs than doctor (1.5% versus 6%) but are more likely to occur within well-child visits. Conclusions. MOs are common in primary care practices, occurring in nearly one-third of visiting children. The risk of under-immunization increases with the increasing percentage of visits that are MOs. Overall strategies directed at reducing MOs need to focus on a range of aspects for the practitioner and the practice system.Keywords
This publication has 11 references indexed in Scilit:
- Recruitment of practices in primary care research: the long and the short of itFamily Practice, 2009
- Determining immunisation coverage rates in primary health care practices: A simple goal but a complex taskInternational Journal of Medical Informatics, 2008
- Delayed immunisation and risk of pertussis in infants: unmatched case-control studyBMJ, 2003
- Missed opportunities to immunize Psychosocial and practice correlatesAmerican Journal of Preventive Medicine, 2002
- Strategies to Sustain Success in Childhood ImmunizationsPublished by American Medical Association (AMA) ,1999
- ImmunizationPublished by American Medical Association (AMA) ,1997
- Missed Opportunities for Immunizations: A Review of the EvidenceJournal of Public Health Management & Practice, 1996
- Impact of Missed Opportunities to Vaccinate Preschool-Aged Children on Vaccination Coverage Levels—Selected U.S. Sites, 1991-1992Published by American Medical Association (AMA) ,1994
- Vaccine coverage: recent trends and future prospects.BMJ, 1992
- The Measles EpidemicJAMA, 1991