Who needs an immunization in a pediatric subspecialty clinic?
W. T. Basco Jr, J. C. Recknor and P. M. Darden
Department of Pediatrics, Medical University of South Carolina, Charleston, USA.
BACKGROUND: The Standards for Pediatric Immunization Practices recommends
that subspecialty clinics screen children's immunization status and ensure
the receipt of needed immunizations. OBJECTIVES: To determine the
proportion of children presenting to a pediatric subspecialty clinic in
whom immunization status can be assessed, and which of those assessed are
due an immunization (eligible to receive an immunization on the day of
clinic visit). DESIGN: Standardized survey of 196 patients or accompanying
children presenting to a pediatric cardiology clinic. Need for
immunizations was determined by the Advisory Committee on Immunization
Practices recommendations. RESULTS: The reason for visit included 58%
return (enrolled in the clinic), 25% initial, and 17% accompanying another
patient. Usual immunization provider included 51% health department, 42%
primary care physician, and 7% military. We could assess the immunization
status of 79 (40%) of 196, and 19 (24%) of these 79 were due an
immunization. Logistic regression analysis revealed that children enrolled
in the clinic were more likely to be due for immunization than those
presenting for initial visits (38% vs 8%; adjusted odds ratio, 7.42; 95%
confidence interval, 1.43 to 38.55). CONCLUSIONS: We could not assess the
immunization status of most children presenting to this pediatric clinic.
Patients enrolled in the clinic were at increased risk for being due
immunization. Having a primary care physician as a provider of
immunizations did not ensure the receipt of immunizations. Pediatric
subspecialists should assess the immunization status of their patients and
make sure that they receive needed immunizations.
