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Research ArticleOriginal Article

Immunization Barriers In A Family Practice Residency Clinic

Debra A. Gamertsfelder, Richard Kent Zimmerman and Elizabeth G. DeSensi
The Journal of the American Board of Family Practice March 1994, 7 (2) 100-104; DOI: https://doi.org/10.3122/jabfm.7.2.100
Debra A. Gamertsfelder
From the Family Practice Residency, Shadyside Hospital (DAG), and the Department of Family Medicine and Clinical Epidemiology (RKZ and EGD), School of Medicine, University of Pittsburgh. Address reprint requests to “Reprints,” Shadyside Family Health Center, 5215 Centre Avenue, Pittsburgh, PA 15232.
MD
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Richard Kent Zimmerman
From the Family Practice Residency, Shadyside Hospital (DAG), and the Department of Family Medicine and Clinical Epidemiology (RKZ and EGD), School of Medicine, University of Pittsburgh. Address reprint requests to “Reprints,” Shadyside Family Health Center, 5215 Centre Avenue, Pittsburgh, PA 15232.
MD, MPH
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Elizabeth G. DeSensi
From the Family Practice Residency, Shadyside Hospital (DAG), and the Department of Family Medicine and Clinical Epidemiology (RKZ and EGD), School of Medicine, University of Pittsburgh. Address reprint requests to “Reprints,” Shadyside Family Health Center, 5215 Centre Avenue, Pittsburgh, PA 15232.
MS
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Abstract

Background: Underimmunization was the primary cause of the 1990 measles outbreak in the United States. We examined the level and causes of underimmunization in a family practice residency clinic that received free vaccine supplies from the county health department.

Methods: The office computer selected 286 patients aged 2 to 3 years. From these 286 patients, 175 were sampled. Their charts were audited for immunization barriers, looking specifically for (1) valid reasons; (2) overly cautious interpretation of contraindications, especially minor illnesses; (3) missed opportunities (failure to address immunization status during acute care visits or lack of simultaneous vaccine administration); (4) parental refusal; and (5) delayed immunizations resulting from gaps in clinic attendance.

Results: There were 174 delayed doses; 90 were due to gaps in clinic attendance, 42 due to valid reasons, 33 due to invalid contraindications, and 25 due to missed opportunities. Some doses were delayed on more than one occasion and for more than one reason. Two parents refused initial immunizations, claiming that the children were too small.

Conclusion: Important causes of delayed immunizations in this residency clinic were gaps in attendance, overly cautious interpretations of contraindications, missed opportunities, and lack of simultaneous vaccine administration.

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The Journal of the American Board of Family     Practice: 7 (2)
The Journal of the American Board of Family Practice
Vol. 7, Issue 2
1 Mar 1994
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Immunization Barriers In A Family Practice Residency Clinic
Debra A. Gamertsfelder, Richard Kent Zimmerman, Elizabeth G. DeSensi
The Journal of the American Board of Family Practice Mar 1994, 7 (2) 100-104; DOI: 10.3122/jabfm.7.2.100

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Immunization Barriers In A Family Practice Residency Clinic
Debra A. Gamertsfelder, Richard Kent Zimmerman, Elizabeth G. DeSensi
The Journal of the American Board of Family Practice Mar 1994, 7 (2) 100-104; DOI: 10.3122/jabfm.7.2.100
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