Change education to boost immunization adherence
Change education to boost immunization adherence
Be ready to answer hard questions about risks
Fifteen years ago, the biggest barrier to immunization was cost. Many families couldn't afford to have their children vaccinated and they didn't have medical coverage. However, in the 1990s, a federal program made vaccines available to all children. Now the biggest barrier to immunization is that parents are choosing not to vaccinate their children, says Paul Offit, MD, chief of infectious diseases at The Children's Hospital of Philadelphia.
"We are a victim of our own success," he says. Because the United States has a high immunization rate, it has the lowest rate of vaccine-preventable diseases it's ever had. Most mothers less than 30 years old have never seen diseases such as mumps and measles, and they didn't grow up with them. Therefore, they deduce that there is no risk from the disease any more and the only real risks are from the vaccine.
Yet, there are 7,000 reported cases of pertussis each year and children die from the disease. One child dies of chicken pox every week, and several thousand are hospitalized annually. The diseases that have been eliminated from the United States, such as polio, have not been eliminated from the world and could be brought in by travelers or immigrants. "When someone doesn't vaccinate their children, they are not putting them in a no-risk situation. They are just choosing to take a different risk, and in the case of vaccines, that risk means disease from the bacteria or virus the vaccines prevented," explains Offit.
Parents hear a lot of conflicting information, yet their health care provider does not have a ready answer to their sophisticated questions. Physicians must be prepared to educate parents about vaccines, addressing concerns that vaccines contain harmful preservatives or cause autism, says Offit. With that in mind, The Children's Hospital of Philadelphia is creating a vaccine information center that will provide physicians with information tear sheets for parents and an informative Web site. (To learn where to find immunization information, see resources box, below.)
A program at Children's Healthcare of Atlanta educates physicians about current immunizations and any changes and updates that have occurred. The health care facility also distributes a quarterly newsletter to clinicians throughout Georgia that contains an insert with hot topics on immunization that can be copied for parents. "We try to make sure that clinicians are properly informed, for they are the ones that have contact with the parents," says Dena Sossaman, MSW, coordinator of immunization and parenting support at Children's Healthcare of Atlanta.
A reminder card for parents is also available. It is often given when staff speak at community functions on topics that are related to children, says Sossaman. There are many vaccines and the schedule can be complicated. "The main message we try to get across to parents is that there is a reason for the vaccine schedule and for the timing and they need to stay as close to that as possible. It could put them at high risk if they don't follow the schedule appropriately," she says. Yet mass-produced education is not the answer because each parent's concerns are a little different, says Sossaman.
Offit agrees. Education must address the concerns the parents have in a modern era. "Parents have questions they didn't have two decades ago. We haven't been very good at answering them and are seeing the consequences," he says.
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