Reflections on North Texas Pediatric Internship

This literature review is an examination of how vaccination rates have changed for pediatric routine immunizations since the outbreak of the COVID-19 pandemic and whether it has impacted specific groups of children. Articles were compiled through the PubMed/Medline database and organized in an evidence table. Decreased vaccination rates for children 0-18 years held true across all sources in a variety of different countries. The most common reason for delay was the fear of being infected with COVID-19. Intervention methods for hesitant parents include reminder systems, walk-in/free clinics, and promoting patient education. It is important to understand the effects COVID-19 has had on pediatric routine vaccinations to prevent the spread of preventable diseases and plan intervention methods accordingly

Literature Review - the vaccine supply chain

Vaccination is one of the most effective ways to prevent the outbreak of an infectious disease. This medical intervention also brings about many logistical quest

EFFECT OF EDUCATION ABOUT PEDIATRIC IMMUNIZATION SCHEDULE AND VACCINE ADMINISTRATION ON FAMILY MEDICINE CLINIC PROVIDERS AND CLINICAL STAFF KNOWLEDGE AND CONFIDENCE

Significance: In this original research, the purpose of this project is to compare and promote increased pediatric immunization knowledge among healthcare providers and clinic staff of a family medicine clinic. In turn, there is greater compliance with the Centers for Disease Control and Prevention’s (CDC) recommended immunization schedule and adherence to vaccinations against the 17 vaccine-preventable diseases. Methods: This exploratory pilot case study surveyed 34 individuals by using an educational tool with information regarding the current CDC-recommended pediatric vaccination schedule. Prior to reviewing the educational material, the participant tested their baseline knowledge about vaccination scheduling and immunization administration. After reviewing the educational tool, a posttest was given with a survey of the participant’s perceived improvement of knowledge and application. Results: Our results suggest that vaccine education for all clinical staff results in improvement of schedule knowledge, vaccine administration knowledge, and vaccine-specific knowledge. Discussion: Overall, the project indicates need for recurrent familiarization of providers and clinical staff with the CDC-recommended pediatric immunization scheduling. The test results indicates benefit from the resources provided and exhibits an increased confidence, as declared subjectively

Literature review: The vaccine supply chain

Vaccination is one of the most effective ways to prevent and/or control the outbreak of infectious diseases. This medical intervention also brings about many logistical questions. In the past years, the Operations Research/Operations Management community has shown a growing interest in the logistical aspects of vaccination. However, publications on vaccine logistics often focus on one specific logistical aspect. A broader framework is needed so that open research questions can be identified more easily and contributions are not overlooked.In this literature review, we combine the priorities of the World Health Organization for creating a flexible and robust vaccine supply chain with an Operations Research/Operations Management supply chain perspective. We propose a classification for the literature on vaccine logistics to structure this relatively new field, and identify promising research directions. We classify the literature into the following four components: (1) product, (2) production, (3) allocation, and (4) distribution. Within the supply chain classification, we analyze the decision problems for existing outbreaks versus sudden outbreaks and developing countries versus developed countries. We identify unique characteristics of the vaccine supply chain: high uncertainty in both supply and demand; misalignment of objectives and decentralized decision making between supplier, public health organization and end customer; complex political decisions concerning allocation and the crucial

Improving Vaccination Rates in Pediatric Primary Care

Objectives: In a small, rural pediatric primary care clinic, the effectiveness of electronic patient portal reminders were evaluated at improving vaccination rates for school required immunizations. Methods: A quality improvement project was initiated utilizing The Social Ecological Model. All pediatric patients were sent reminders who were under-immunized. This QI project evaluated the effectiveness of vaccine reminders on the improvement of immunization rates in the clinic Results: Total number of fully-vaccinated patients within the practice improved (2%) and patients under-immunized decreased by 1%. 87 immunizations were given to patients were given to patients who were under-immunized and an average of 10% of recorded un-vaccinated patient prior to intervention received at least one immunization. Conclusions: Implementation of vaccine reminders into a rural primary care pediatric practice improved patient compliance with school-required vaccines. Although immunization rates improved, the practice continues to see higher rates of under-immunized patients compared to state reporting data. Key Words: Vaccines, improvement, pediatric, primary care, portal reminder, vaccination rate

Barriers to vaccination service delivery within general practice: Opportunity to make a sustainable difference in Aboriginal child health?

Objective: To identify behavioural barriers of service provision within general practice that may be impacting the vaccination coverage rates of Aboriginal children in Perth, Western Australia (WA). Methods: A purposive developed survey was distributed to 316 general practices across Perth and three key informant interviews were conducted using a mixed-methods approach. Results: Of the surveyed participants (n=101), 67.4% were unaware of the low vaccination coverage in Aboriginal children; 64.8% had not received cultural sensitivity training in their workplace and 46.8% reported having inadequate time to follow up overdue child vaccinations. Opportunistic vaccination was not routinely performed by 30.8% of participants. Key themes identified in the interviews were awareness, inclusion and cultural safety. Conclusion: Inadequate awareness of the current rates, in association with a lack of cultural safety training, follow-up and opportunistic practice, may be preventing greater vaccination uptake in Aboriginal children in Perth. Cultural safety is a critical component of the acceptability and accessibility of services; lack of awareness may restrict the development of strategies designed to equitably address low coverage. Implications: The findings of this study provide an opportunity to raise awareness among clinicians in general practice and inform future strategies to equitably deliver targeted vaccination services to Aboriginal children

Vaccination guidance during a pandemic

The COVID-19 pandemic has caused healthcare providers to change how they operate to continue to provide essential services to patients. Ensuring immunization services are maintained or reinitiated is essential for protecting individuals and communities from vaccine-preventable diseases and outbreaks and reducing the burden of respiratory illness during the upcoming influenza season.The following are a collection of federal resources designed to guide vaccine planning during the COVID-19 pandemic2020779

Early impact of the coronavirus disease (COVID-19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020.

Using electronic health records, we assessed the early impact of coronavirus disease (COVID-19) on routine childhood vaccination in England by 26 April 2020. Measles-mumps-rubella vaccination counts fell from February 2020, and in the 3 weeks after introduction of physical distancing measures were 19.8% lower (95% confidence interval: -20.7 to -18.9) than the same period in 2019, before improving in mid-April. A gradual decline in hexavalent vaccination counts throughout 2020 was not accentuated by physical distancing

Vaccination guidance during a pandemic

The COVID-19 pandemic has caused healthcare providers to change how they operate to continue to provide essential services to patients. Ensuring immunization services are maintained or reinitiated is essential for protecting individuals and communities from vaccine-preventable diseases and outbreaks and reducing the burden of respiratory illness during the upcoming influenza season.Interim Guidance for Immunization Services During the COVID-19 Pandemic -- Vaccination Recommendations during the COVID-19 Pandemic.2020781

Immunization Milestones: A More Comprehensive Picture of Age-Appropriate Vaccination

A challenge facing immunization registries is developing measures of childhood immunization coverage that contain more information for setting policy than present vaccine series up-to-date (UTD) rates. This study combined milestone analysis with provider encounter data to determine when children either do not receive indicated immunizations during medical encounters or fail to visit providers. Milestone analysis measures immunization status at key times between birth and age 2, when recommended immunizations first become late. The immunization status of a large population of children in the Oregon ALERT immunization registry and in the Oregon Health Plan was tracked across milestone ages. Findings indicate that the majority of children went back and forth with regard to having complete age-appropriate immunizations over time. We also found that immunization UTD rates when used alone are biased towards relating non-UTD status to a lack of visits to providers, instead of to provider visits on which recommended immunizations are not given