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Posted: May 14th, 2020

Increasing Childhood Vaccination Compliance

# Increasing Childhood Vaccination Compliance

Vaccinations are one of the most effective public health interventions for preventing and reducing the burden of many infectious diseases. However, vaccination coverage among children and adolescents is still suboptimal in many countries, and there are significant disparities based on economic and racial factors. This blog post will discuss some of the interventions that can improve immunization rates among school-aged children and adolescents, and why it is important to catch up on missed doses as soon as possible.

## Why is vaccination important?

Vaccination protects not only the individual who receives the vaccine, but also the community around them. By creating herd immunity, vaccination can prevent the spread of diseases that can cause serious complications and even death, especially for those who are vulnerable, such as infants, elderly, or immunocompromised people. Vaccination can also reduce the costs of health care and social services associated with treating preventable diseases.

Some of the diseases that can be prevented by vaccination include measles, mumps, rubella, polio, tetanus, diphtheria, pertussis, hepatitis B, meningococcal disease, human papillomavirus (HPV), influenza, and COVID-19. These diseases can have severe consequences, such as brain damage, paralysis, cancer, infertility, and birth defects.

## What are the barriers to vaccination?

There are many factors that can affect vaccination coverage among children and adolescents. Some of these factors include:

– Lack of access to health care services or transportation
– Cost of vaccines or co-payments
– Inadequate supply or storage of vaccines
– Lack of awareness or information about the benefits and safety of vaccines
– Misconceptions or mistrust about vaccines or health care providers
– Religious or philosophical objections to vaccines
– Fear of needles or side effects
– Competing priorities or busy schedules

## What are the interventions to increase vaccination coverage?

There are various strategies that can be implemented at different levels to increase vaccination coverage among children and adolescents. Some of these strategies include:

– Education: Providing accurate and tailored information to parents, children, and adolescents about the importance and safety of vaccines, and addressing their concerns and questions.
– Reminders: Sending messages or calls to parents, children, and adolescents to remind them about their due or overdue vaccinations, and providing appointment scheduling assistance.
– Provider-directed interventions: Training and motivating health care providers to assess and recommend vaccinations to their patients, and providing them with feedback and incentives.
– Financial incentives: Offering rewards or reducing costs for parents, children, and adolescents who receive vaccinations.
– Multilevel interventions: Combining two or more strategies at different levels (e.g., individual, family, community, health system) to enhance their impact.
– School-based clinics: Providing vaccinations at schools or requiring vaccinations for school entry or attendance.
– Policy and legislation: Enacting laws or regulations that mandate or facilitate vaccinations for certain groups or settings.

## What is the evidence for these interventions?

Several studies have evaluated the effectiveness of these interventions on increasing vaccination coverage among children and adolescents. A meta-analysis by Siddiqui et al. (2022) found that education may increase overall vaccination coverage by 19%, reminders by 15%, provider-directed interventions by 13%, financial incentives by 67%, and multilevel interventions by 25%. However, the impact of school-based clinics and policy and legislation on overall vaccination coverage is still uncertain, and no impact of a multicomponent intervention was found.

Another review by The Community Guide (2015) found that client reminder and recall systems were effective in increasing vaccination rates for various vaccines (e.g., influenza, HPV, meningococcal) among different populations (e.g., children aged 5–18 years; adolescents aged 11–18 years). The review also found that provider reminder systems were effective in increasing vaccination rates for various vaccines (e.g., influenza; tetanus-diphtheria-acellular pertussis; measles-mumps-rubella) among different populations (e.g., children aged 6 months–18 years; adolescents aged 11–18 years).

## What are the implications for practice?

These findings suggest that there are several interventions that can improve vaccination coverage among school-aged children and adolescents. However, these interventions need to be tailored to the specific context and needs of each population. For example, some interventions may be more effective for certain vaccines than others, or for certain groups than others. Moreover, some interventions may require more resources or collaboration than others.

Therefore, health care providers, public health professionals, policy makers, educators, parents, and children and adolescents themselves need to work together to identify the best strategies to increase vaccination coverage in their communities. They also need to monitor and evaluate the outcomes and impacts of these strategies on a regular basis.

## Conclusion

Vaccination is a vital tool for protecting children and adolescents from preventable diseases and their complications. However, vaccination coverage is still suboptimal and uneven among this population. There are various interventions that can increase vaccination coverage, such as education, reminders, provider-directed interventions, financial incentives, multilevel interventions, school-based clinics, and policy and legislation. These interventions need to be adapted and implemented according to the specific needs and preferences of each population. By increasing vaccination coverage, we can improve the health and well-being of children and adolescents, as well as the society as a whole.

## References

– Siddiqui FA, Padhani ZA, Salam RA, Aliani R, Lassi ZS, Das JK, Bhutta ZA. Interventions to improve immunization coverage among children and adolescents: a meta-analysis. Pediatrics. 2022;149(Supplement 6):e2021053852D. https://doi.org/10.1542/peds.2021-053852D
– The Community Guide. Increasing appropriate vaccination: client reminder and recall systems. 2015. https://www.thecommunityguide.org/findings/vaccination-client-reminder-and-recall-systems
– CDC. Reminder systems and strategies essypro for increasing childhood vaccination rates. 2020. https://www.cdc.gov/vaccines/hcp/admin/reminder-sys.html
– Georgetown University Center for Children and Families write my dissertation in UK. Urgent action needed to catch up on routine childhood vaccinations. 2021. https://ccf.georgetown.edu/wp-content/uploads/2021/07/Kids-and-Vaccines-v4.pdf
– CDC. Resources to encourage routine childhood vaccinations. 2021. https://www.cdc.gov/vaccines/partners/childhood/stayingontrack.html

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