The organization, delivery and audit of a specialist immunization clinic

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Abstract
Immunization is a key primary prevention activity which has assisted in the reduction of childhood morbidity and premature mortality. Uptake rates for two‐year‐old children are now in excess of 90 per cent throughout the UK and for the vast majority of infants immunization is a routine procedure with a high benefit‐to‐risk ratio. Concerns about particular children, either because of their previous medical history or an adverse vaccine event, have been responded to in various ways. The experiences of a specialist immunization facility established in 1987, which since inception has seen just over 3,000 children are described. The clinic operates four sessions a week, with two held in the District General Hospital and two in community clinics; the resource requirements for the clinic are identified. A parent satisfaction survey for the first 1,700 attenders was undertaken in 1992 and the results are reported; their comments led to changes in the method of service delivery. A study of GPs′ views was also undertaken at the same time; their satisfaction with the service is reflected in the continuing level of referrals. It is believed that all provider units should consider developing a similar facility for five reasons. First, it provides a source of expert advice for both professionals and parents; second, it facilitates the immunization of children with problem histories; third, it enables the investigation of serious post‐vaccination adverse events; and fourth, the clinic provides a means of co‐ordinating and delivering neonatal immunizations (including BCG, HBV, Varicella zoster and the vaccination of pre‐term infants). And finally the clinic offers training for health care staff involved in primary immunization programmes and travel vaccination services.