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Delaying vaccinations at sick visits did not improve well-baby visit rates
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When deciding to delay vaccinations at sick visits, physicians should consider the risk that infants will not return for a timely makeup well-baby visit, according to findings in a recent study published in Pediatrics.
“Giving timely immunizations to children against vaccine-preventable disease is one of the most useful preventive services performed by clinicians,” Steve G. Robison, BS, of the Oregon Immunization Program, wrote in the study. “However, the complexity of the AAP/Advisory Committee on Immunization Practices early childhood immunization schedule, in which multiple shots are due on ≥5 visits before age 2 years, can have the unintended consequence that children who fall behind the vaccination schedule are difficult to catch back up.”
The retrospective cohort analysis included 1,060 infants aged 2, 4 or 6 months who had a sick visit for acute otitis media instead of a normal well-baby visit.
Robison found that 7.5% of participants received a sick-visit vaccination, 56.7% did not have a sick-visit vaccination but returned for a well-baby visit within 4 weeks, and 35.8% did not have a sick-visit vaccination or a quick makeup well-baby visit.
He also found that pediatricians were more likely to administer vaccinations at a sick visit than family or general practitioners (RR=3.29; 95% CI, 1.38-7.99).
“Increasing the delivery of needed immunizations at sick visits should remain as a goal to decrease the number of infants who fall behind and do not catch up with the recommended schedule,” Robison wrote.
Disclosure: The study was supported by a grant from CDC.
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