Providing immunizations in a pediatric emergency department: Underimmunization rates and parental acceptance

Objectives: To assess the vaccination status and vaccinate eligible childre n with age-appropriate antigens, Design: Intervention. Setting: Pediatric emergency department in an urban, public hospital. Patients: Convenience sample of children, aged birth through 72 months. Interventions: Immunization of eligible children. Main Outcome Measures: 1) Immunization coverage rates in the sample populat ion, 2) Acceptance rates of immunization. Results: A total of 9321 children were enrolled over a 2-year period. Fifty -nine percent were documented to be underimmunized, Overall, 2514 children received a total of 6482 immunizations. Parents who carried portable immuni zation cards documenting that their child was underimmunized were almost fi ve times more likely to accept immunization for their child than parents wh o lacked documentation (71% vs 15%, P < 0.0001). The estimated cost of prov iding immunizations in the emergency department was $47.15 per child immuni zed, or $18.56 per immunization given. Conclusions: The majority of children with documentation of immunization st atus were underimmunized, When documentation of underimmunization was avail able, parents were significantly more likely to accept vaccination, These d ata suggest that vaccinating children in nontraditional settings is feasibl e and support the creation of an accessible vaccine registry.