PARENT REPORTS ON WILLINGNESS TO ACCEPT CHILDHOOD IMMUNIZATIONS DURING URGENT CARE VISITS

Objectives. To 1) describe whether parents would be willing to accept childhood immunizations at urgent care visits; and 2) identify predict ors of parents' willingness to accept childhood immunizations at urgen t care visits. Design and Participants. Cross-sectional telephone surv ey of parents of children aged 18 to 24 months who were underimmunized according to a computerized immunization tracking system and who had recently made an urgent care visit in a regional group-model health ma intenance organization in Northern California. Chart review was conduc ted to confirm immunization status and to identify contraindications t o vaccination. Results. Of the 424 eligible participants, 351 (83%) co mpleted interviews. Children with contraindications to vaccination and children who were actually up-to-date at the time of the urgent care visit were excluded, leaving 263 families in the final analysis. Among these parents, 75% said they would have been willing to have their ch ild immunized at the urgent care visit in question if the physician ha d suggested it. An additional 11% said they would have accepted vaccin ation if the physician told them that the shot would be safe and stron gly encouraged them to accept it. Overall, 86% :reported they theoreti cally would have accepted an immunization during the urgent care visit . In the multivariate analysis, the strongest predictors of stated wil lingness to accept shots at the urgent care visit were the parent: 1) not being aware that their child was underimmunized (odds ratio [OR] 3 .5, 95% confidence interval [CI], 1.6-7.7); 2) perceiving that the chi ld was not very sick at the visit (OR 1.8, 95% CI, 1.1-3.0); 3) being less concerned about the risk of shots (OR 1.8, 95% CI, 1.2-2.5); and 4) being of nonwhite race (OR 3.6, 95% CI, 1.6-7.7). Income and educat ion were not significantly associated with reported willingness to acc ept immunization. Conclusions. We conclude that most parents of underi mmunized toddlers report being willing to accept immunizations during urgent care visits if the clinician recommends it. More effective ways of alerting providers in urgent care settings when immunizations are due, such as indications on a chart or registration form, hold promise for improving immunization coverage rates. p://www.pediatrics.org/cgi /content/full/102/4/e47.