Factors Influencing Immunization Status in Primary Care Clinics

Background and Objectives: National standards and goals for childhood immunization rates are well established. Yet, despite clear standards and goals, physicians do not achieve the desired rate (90%) for immunization coverage. This study examined factors related to immunization status for 2-year-old children in pediatric and family practice settings. Methods: Specially trained personnel used computer software to audit 2,552 records from 42 practices in Northeast Florida throughout 1997–1999. Immunization records were judged as either complete or incomplete, and factors related to immunization status were studied. Clinic type and 18 immunization practice standards were reviewed for effect on immunization status. Results: The probability of complete immunization status for children in pediatric clinics was greater than for those in family practice clinics. Multivariate logistic regression revealed that use of semiannual audits (odds ratio [OR]=2.00, confidence interval [CI]=1.65–2.42) was the most important factor for immunization completion. This was followed by availability of discounted immunizations (OR=.44, CI=.27–.73) and the use of an immunization tracking system (OR=1.48, CI=1.18–1.70). Factors that were not found to contribute included clinic type and the remaining 15 practice standards. Conclusions: Considering the significant factors, immunization status was not affected by the type of clinic providing immunizations. Based on this analysis, family physicians should implement tracking systems and should perform semiannual audits to match the success of pediatricians in immunizing children. Neither group met nationally established goals for administration of immunizations for 2-year-old children

Preventive youth health care in 11 European countries: an exploratory analysis

Objective: To systematically identify similarities and differences in the way preventive youth health care (YHC) is organized in 11 European countries. - \ud Method: Questionnaire survey to EUSUHM (European Union for School and University Health and Medicine) representatives. - \ud Results: The greatest similarities were found in the age range of the YHC target group and the separation of curative and preventive services. Croatia, Germany and Switzerland show the greatest differences when compared to other European countries, for example, in the access to medical records, YHC professional input and the number of examinations, immunizations and screenings. In eight countries YHC is financed by national insurances or taxation. In Germany, FYR Macedonia, the Netherlands, Russia and Switzerland, different forms of financing exist in parallel. - Conclusion The results should be interpreted as a preliminary step in mapping organizational features of YHC in Europe

The Effectiveness of California Assembly Bill 2109: Personal Belief Exemptions for Kindergarten Immunizations

The numbers of vaccine preventable diseases (VPDs) in the United States has declined with the development, administration, and effectiveness of vaccines during the 1970s and 1980s. As the eminent threat of VPDs to the public began to wane, parents started questioning the safety and necessity of vaccines. When parents were given the option of selecting personal belief exemption (PBE) waivers for state mandated immunizations for their incoming kindergarten children, an increase in PBEs and the number of VPD outbreaks began to occur. To counter the growing trend of PBEs, and to prevent outbreaks of VPDs in school settings and communities, California Assembly Bill2109 (AB 2109, 2012) was created to help educate parents about vaccine safety and VPDs. As of January 2014, California Assembly Bill2109 (AB 2109, 2012) mandated that parents seeking PBEs for state mandated immunizations for students entering kindergarten were required to receive education about vaccine safety and risks along with education regarding VPDs by a health care professional (AB 2109, 2012). The purpose of this study was to examine the effectiveness of AB 21 09 by examining data from the top ten most populous counties in California. Data was collected for the 2013-2014, 2014-2015, and 2015- 2016 school years to determine if AB 2109 directly impacted the number of PBEs for incoming kindergartners. This project determined that AB 2109 was significant in decreasing the number 3 of PBEs from the 2013-2014,2014-2015, and 2015-2016 school years by -23.4% in the ten most populous counties in California. Further research beyond this project is necessary to evaluate the continued impact of AB 2109 on PBEs and in decreasing the number of VPD outbreaks throughout California

Supporting Our Youngest Children: Early Head Start Programs in 2010

Reviews research about the impact of Early Head Start programs on the health and development of poor children under age 3 and their parents' knowledge and parenting, trends in enrollment, program options, and characteristics of teachers and enrollees

Engaging in Culturally Informed Nursing Care with Hmong Children and Their Families

The Hmong are an ethnic hill tribe group originally from Southern China with concentrated populations throughout Southeast Asia, especially the mountains of northern Laos. Following the Vietnam War, the Hmong started immigrating to the United States in waves to escape prosecution for fighting communism alongside the United States. Today, the Hmong population in the United States is growing rapidly, with a median age of 20.4 years. As the Hmong move and redistribute themselves across the country to be with family or pursue new opportunities, it is more and more likely that nurses everywhere will interact with Hmong children and their families. Historically medically underserved, the Hmong community continues to face barriers to healthcare as a result of culture, language, and lack of access. Nurses who are informed about cultural values and norms of the Hmong and their family and social structures, as well as their spiritual and traditional practices, will be able to establish trust with their pediatric patients and their caregivers. Utilizing strategies including interpretive services, asking detailed social and physical histories, providing extra appointment time, asking open ended questions, and employing teach back methods can help improve communication as well as provide higher quality care that addresses the specific needs of this population

Shortchanging America's Health 2008: A State-by-State Look at How Federal Public Health Dollars Are Spent

Examines public health indicators in each state, in combination with federal and state funding for programs to promote health. Includes state rankings by funding per capita, percentage of population who are uninsured, disease rates, and other indicators

Long Term and Short Term Effects of Perturbations in a Immune Network Model

In this paper we review the trajectory of a model proposed by Stauffer and Weisbuch in 1992 to describe the evolution of the immune repertoire and present new results about its dynamical behavior. Ten years later this model, which is based on the ideas of the immune network as proposed by Jerne, has been able to describe a multi-connected network and could be used to reproduce immunization and aging experiments performed with mice. Besides its biological implications, the physical aspects of the complex dynamics of this network is very interesting {\it per se}. The immunization protocol is simulated by introducing small and large perturbations (damages), and in this work we discuss the role of both. In a very recent paper we studied the aging effects by using auto-correlation functions, and the results obtained apparently indicated that the small perturbations would be more important than the large ones, since their cumulative effects may change the attractor of the dynamics. However our new results indicate that both types of perturbations are important. It is the cooperative effects between both that lead to the complex behavior which allows to reproduce experimental results.Comment: 15 pages, 5 figure

Immunizations - Not Just for Kids

Immunizations/vaccinations are beneficial for most people of all ages. Yet the mistaken belief persists that, with the exception of the flu vaccine, children should be the primary recipients of this important area of primary disease prevention. In fact, older persons require immunization as well. As people grow older they become increasingly vulnerable to a variety of illnesses, and, as informal caregivers of young children, grandparents need to be sensitive to their role in preventing the spread of contagious diseases to the young

Attitudes Towards Vaccination Among Medical Students: A Two-Site Study

Introduction: Mandatory immunization for school age children in the 20th Century led to a substantial decline in infectious disease. All US states allow medical exemptions from immunizations with 49 permitting additional religious exemptions and 19 permitting additional philosophical exemptions. Vaccine exemptions have lead to an increase in the incidence of disease outbreaks. Healthcare providers play a critical role in educating parents about the benefits and risks of immunizations. This project compares student attitudes and knowledge regarding vaccination at medical schools in two distinct states: one with no additional exemptions (West Virginia) and one with both additional exemptions (Vermont).https://scholarworks.uvm.edu/comphp_gallery/1218/thumbnail.jp