Allison Kennedy

Parental and provider preferences and concerns regarding text message reminder/recall for early childhood vaccinations

OBJECTIVE To assess parental, provider, and medical staff opinions about text message reminder/recall for early childhood vaccination. METHODS A cross-sectional survey was conducted between January and March 2011 among 200 parents of 6-59 month-old children, 26 providers, and 20 medical staff at four academically-affiliated pediatric practices in New York City with text messaging experience. Survey questions addressed interest in, preferences for, and concerns/barriers related to vaccine-related text message reminder/recall. RESULTS Parents were primarily Latino, Spanish-speaking, and had a high school education or less. Most parents owned a text message-enabled cell phone (89%) and used text messaging services (97%). While 84% had never received health-related text messages, 88% were comfortable receiving them. Nearly all parents reported interest in receiving reminder/recall text messages, many endorsing them over phone calls and/or letters. Preferences included personalization, interactivity, and multiple messages. While 25% of parents had no concerns, 38% were concerned about incorrect numbers; only 6% worried about cost. Providers and staff were also supportive of vaccine-related text messages. Their biggest concerns were correct cell phone numbers, appointment availability, and increased call volume. CONCLUSION Text message reminder/recall for early childhood vaccination was widely supported. Important barriers were identified that should be addressed to maximize their effectiveness.

Adult vaccination coverage levels among users of complementary/alternative medicine - results from the 2002 National Health Interview Survey (NHIS).

BackgroundWhile many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged ≥ 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage.MethodsData from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and ≥ 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics.ResultsOverall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001).ConclusionVaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in keeping with their commitment to maintaining good health.

Early Experience Conducting School-located Vaccination Programs for Seasonal Influenza

OBJECTIVES We determined program effectiveness, feasibility, and acceptance of school-located vaccination (SLV) clinics for seasonal influenza that took place before the 2008 universal influenza vaccination recommendations. METHODS We surveyed program directors of 23 programs in the United States who conducted SLV clinics during the 2005 to 2006 and 2006 to 2007 influenza seasons. RESULTS Of 391 423 children enrolled in schools with SLV clinics, 61 463 (15.7%) were vaccinated at 499 sites (schools) in 23 programs. Of these, 22 were small- and medium-sized programs that vaccinated 32 875 (24.1%) of the 136 151 children enrolled there, averaging 31.9% of students per site. One populous county vaccinated an additional 28 588 (11.2%) of its 255 272 enrolled children, averaging 13.9% per school. Children in grades K to 6 had consistently higher mean vaccination rates (21.5%) compared with middle school children (10.3%) or high school youth (5.8%). Program acceptability was high, and no program had to forego any key public health activities; 5 hired temporary help or paid overtime. The outlook for continuing such clinics was good in 7 programs, but depended on help with vaccine purchasing (9), funding (8), or additional personnel (4), with multiple responses allowed. CONCLUSIONS These vaccination coverage rates provide a baseline for future performance of school-located mass vaccination clinics. Although the existence and conduct of these programs in our study was considered acceptable by leaders of public health departments and anecdotally by parents and school administrators, sustainability may require additional means to pay for vaccines or personnel beyond the usual available health department resources.

Limited Awareness of Vaccines Recommended for Adolescents and Other Results from Two National Consumer Health Surveys in the United States

PURPOSE This study describes the vaccine-related knowledge and attitudes of adolescents aged 11-18 years and parents of adolescents aged 11-18 years. METHODS We analyzed the 2007 HealthStyles and YouthStyles surveys related to vaccine knowledge and attitudes of parents (n = 1,208) and adolescents (n = 1,087). RESULTS In all, 21% of parents and 11% of adolescents correctly identified the three vaccines recommended at the time of the survey for adolescents. Regarding the hypothetical scenario that minor adolescents should be allowed to consent to vaccination without parental knowledge, 70% of parents and 72% of adolescents disagreed. The majority of parents and adolescents recognized the importance of vaccines in protecting an adolescents health yet a substantial minority of both groups also reported concerns about vaccine safety. CONCLUSIONS Many parents and adolescents surveyed were not aware of all vaccine recommendations for adolescents and did not support adolescents receiving vaccinations independent of parental knowledge and/or consent.