Impact of Community Volunteers on Immunization Rates of Children Younger Than 2 Years

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Abstract

Objective

To assess the effectiveness of a volunteer-driven outreach program on immunization rates in children younger than 2 years.

Design

Randomized controlled trial.

Setting

Pediatric ambulatory clinics in New York, NY.

Patients

A total of 163 children were randomly assigned to receive services from the volunteer-driven outreach program or to serve as control subjects. All children were (1) younger than 2 years, (2) no-shows for a scheduled appointment in the pediatric clinic, and (3) due or overdue for a vaccine.

Intervention

Immunization outreach, tracking, and follow-up were provided by community volunteers throughout follow-up (mean, 6.5 months). Control children were notified of immunization status at enrollment but received no further contact until the conclusion of follow-up (mean, 6.4 months).

Main Outcome Measure

Immunization status 6 months after enrollment.

Results

Significantly more intervention children were up-to-date with their vaccination series than controls (75% vs 54%; P=.03). Children in the control group were 2.8 times more likely to be late for a vaccine than intervention children (odds ratio=2.8; P=.02). In addition, an immunization delay of longer than 30 days at enrollment was a significant predictor of final immunization delay (odds ratio=2.6; P=.02).

Conclusions

This volunteer-driven program significantly improved immunization rates among intervention children compared with controls. Results confirm previous findings that indicate an increased risk of an incomplete immunization series by 2 years of age among children who fall behind early in their primary vaccination series. However, control children were almost 3 times more likely to be late (for >or= to 1 vaccines) than intervention children, regardless of whether an earlier immunization delay was present.

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