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Vaccine Education Center
Immunization Action CoalitionIn 2000, our nation set a new preventive health goal for itself - to achieve immunization rates of 90% for universally recommended vaccines among children aged 19-35 months by 2010. While some states have come close to this goal, there are still several states with immunization rates that are alarmingly low, putting children at risk for vaccine-preventable diseases (VPDs) (click here to view state immunization rates).
The providers delivering health care services are essential to the success of any immunization effort. There are many potential barriers that can interfere with the immunization of children. These barriers may occur at the healthcare system level, the provider level and/or the family level. For example, within the healthcare system, some policies that may result in low immunization rates include high co-payments or high deductibles required for immunization.
Vaccine shortages, delays and distribution problems can occur, as the U.S. experienced with the pneumococcal conjugate vaccine (PCV7) and influenza vaccines. The complexity of the immunization schedule may confuse parents and creates a challenge for providers as well.
On the provider level, lack of knowledge about current recommended immunization schedules/contraindications, lack of proper documentation of immunizations in patients’ medical records, lack of understanding of reimbursement policies or inadequate reimbursement, having immunizations available by appointment only, and missed opportunities to vaccinate can add to the number of children who are not fully vaccinated.
On the family/community level, parental attitudes, knowledge, and behavior may contribute to low immunization rates. For example, parents may mistakenly believe that their children are fully vaccinated when in fact they are not or they may have concerns about the safety of vaccines or the number of vaccines that their children are being given. In addition, language barriers may lead to miscommunication between parents and providers and add to parent's confusion about vaccinations.
To avoid missed opportunities, each contact with a child (well and sick visits) should be used by providers as an opportunity to review the child's immunization status and when appropriate, to vaccinate. This is particularly critical for high-risk children.