"If reminder or recall messages can be generated for entire populations within a county by the state and county health departments, this unburdens the primary care practice and is much less expensive overall," Kempe said. "It also has the advantage of reaching children who do not have a usual source of primary care. Our data from surveys of both parents and providers suggest that there is strong support for this approach."
The Community Preventive Services Task Force recommends the use of reminder/recall for increasing immunization rates. Current national data suggest that only 16 percent of providers are doing any type of reminder/recall for immunizations. The reasons for this include competing demands, staff turnover, costs related to mailings or telephone call reminders and the lack of computerized systems identifying who need immunizations.
There is increased interest in determining whether reminder/recall efforts might be more feasible and less costly to conduct centrally by public health departments using a regional or state Immunization Information System.
The study's authors conducted a cluster-randomized trial involving children 19-35 months in need of immunizations in eight rural and six urban Colorado counties. In population-based recall counties, recall was conducted centrally using the Colorado Immunization Information System (CIIS). In practice-based recall counties, practices were invited to attend CIIS training and offered financial support for mailing.
Six months after recall, they compared the percentage of children who became up-to-date on vaccines and found significant differences. Among the 32,125 children needing immunizations, 18.7 percent became up-to-date in population-based recall versus 12.8 percent in practice-based recall. Population-based recall was also more cost effective, wi
|Contact: David Kelly|
University of Colorado Denver