Abstract
BackgroundImmunizations have reduced childhood vaccine preventable disease incidence by 98–100%. Continued vaccine preventable disease control depends on high immunization coverage. Immunization registries help ensure high coverage by recording childhood immunizations administered, generating reminders when immunizations are due, calculating immunization coverage and identifying pockets needing immunization services, and improving vaccine safety by reducing over-immunization and providing data for post-licensure vaccine safety studies. Despite substantial resources directed towards registry development in the U.S., only 48% of children were enrolled in a registry in 2004. Parental attitudes likely impact child participation. Consequently, the purpose of this study was to assess the attitudes of parents of vaccinated and unvaccinated school-aged children regarding: support for immunization registries; laws authorizing registries and mandating provider reporting; opt-in versus opt-out registry participation; and financial worth and responsibility of registry development and implementation.MethodsA case control study of parents of 815 children exempt from school vaccination requirements and 1630 fully vaccinated children was conducted. Children were recruited from 112 elementary schools in Colorado, Massachusetts, Missouri, and Washington. Surveys administered to the parents, asked about views on registries and perceived utility and safety of vaccines. Parental views were summarized and logistic regression models compared differences between parents of exempt and vaccinated children.ResultsSurveys were completed by 56.1% of respondents. Fewer than 10% of parents were aware of immunization registries in their communities. Among parents aware of registries, exempt children were more likely to be enrolled (65.0%) than vaccinated children (26.5%) (p value = 0.01). A substantial proportion of parents of exempt children support immunization registries, particularly if registries offer choice for participation. Few parents of vaccinated (6.8%) and exempt children (6.7%) were aware of laws authorizing immunization registries. Support for laws authorizing registries and requiring health care providers to report to registries was more common among parents of vaccinated than exempt children. Most parents believed that the government, vaccine companies or insurance companies should pay for registries.ConclusionParental support for registries was relatively high. Parental support for immunization registries may increase with greater parental awareness of the risks of vaccine preventable diseases and utility of vaccination.
Highlights
Immunizations have reduced childhood vaccine preventable disease incidence by 98–100%
Surveys were returned by 391(48.6%) of the 805 parents of exempt children and 976 (59.9%) of the 1630 parents of fully vaccinated children, for an overall response rate of
Support for laws authorizing registries and requiring health care providers to report to registries was more common among parents of vaccinated than exempt children, parents with children exempt for only one antigen expressed similar support as parents of vaccinated children (Table 3)
Summary
Immunizations have reduced childhood vaccine preventable disease incidence by 98–100%. Immunization registries help ensure high coverage by recording childhood immunizations administered, generating reminders when immunizations are due, calculating immunization coverage and identifying pockets needing immunization services, and improving vaccine safety by reducing over-immunization and providing data for post-licensure vaccine safety studies. Immunizations have been tremendously successful in the United States, reducing childhood vaccine preventable diseases (VPDs) by 98–100% [1,2]. Immunization registries can be used for measuring vaccine coverage, generating reminders when immunizations are due and recalls when immunizations are overdue, identifying pockets of need for targeted interventions, improving vaccine safety by reducing overimmunization and calculating accurate denominators important for post-licensure vaccine safety studies, as well as many other important public health functions [4]. Immunization registries must be fully operational and contain complete immunization records in order for their potential to be wholly realized
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