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CAN WE RELY ON PARENT/CARER RECALL OF VACCINATION STATUS IN THE PAEDIATRIC EMERGENCY DEPARTMENT, OR IS IT TIME FOR AN ALTERNATIVE SOURCE OF DATA?
Abstract
Background
Despite vaccination being one of the great global public health successes, uptake amongst children and young people (CYP) remains below WHO targets for many diseases. UK guidance recommends vaccination status be checked routinely in all healthcare settings, e.g. the Paediatric Emergency Department (PED). This is most commonly done via a basic question such as “Is this child up-to-date?”.
Aims
The aim of this work was to estimate the accuracy of parent/carer recall (the routine source of data during a PED consultation). It is part of a project exploring the potential for PED-based vaccination interventions, with an initial focus on ways of reliably identifying those at higher risk of being under-immunised.
Methods
Full ethics approval was obtained. Participants were recruited from attendees (< 16 years old) at one PED in England. Parents/carers were asked if the attendee was up-to-date with vaccinations (yes/no/not sure) and consent was requested to access community-held vaccination records (assumed to be correct as vaccines are mostly given in the community).
Results
Only 4% of CYP were reported by parents/carers as not being fully immunised, however community-held records showed this figure to be 14%. Nearly one in five (18%) of parents/carers inaccurately reported their child’s status, with the majority over-estimating vaccination coverage.
Conclusions
CYP attending the PED may benefit from targeted interventions to improve their vaccination coverage. However, parent/carer recall is not sufficiently reliable as a source of accurate vaccination data. More work needs to be done to look at alternative sources of data for identifying under-vaccinated CYP during a PED visit.