Monday, March 06, 2006


Shots not up to date for many children
One-third in Ontario behind in vaccinations
Study authors puzzled by immunization lag
Mar. 6, 2006. 01:00 AM

One-third of Ontario children under the age of 2 are behind in their vaccinations, a new study shows, despite province-wide free access to the life-saving shots.
And that, says Dr. Astrid Guttmann, lead author of the study by the Institute of Clinical Evaluative Sciences, can cause disease among unprotected children and adults.
"Childhood immunization is one of the most cost-effective interventions in health care," Guttmann said, pointing to a recent resurgence of whooping cough in the Toronto area and last spring's outbreak of rubella in southwestern Ontario.
Health Canada's target is a 95 per cent immunization rate for the 2 and under group, the study notes.
The lag in keeping vaccinations up to date is puzzling, say the study's authors, since they found that visits to the doctor's office for children in those first two years of life are high, with an average of 19 visits per child.
"That's almost monthly," Guttmann noted.
"Low immunization rates are concerning," she added. "The children are going to their physicians a lot during the first two years of life, but they aren't getting all their immunizations."
Guttmann said one answer is more well-baby visits to the doctor, when babies can be immunized against the major diseases.
Children are considered up-to-date if they've had at least five immunizations by age 2 — the recommended three doses and one booster for Hemophilus influenza, pertussis (whooping cough), diphtheria, polio and tetanus to be given at two, four, six and 18 months; and one combined dose of measles, mumps and rubella to be given after the first birthday.
Since doctor visit rates are high, the study suggests doctors become more vigilant in seeing that children are immunized on schedule. One answer is computerized health records to alert doctors when a child is behind on vaccinations.
The study, published today in Pediatrics, the journal of the American Academy of Pediatrics, looked at the physician billing records for 101,570 infants born in urban Ontario between July 1997 and June 1998.
The findings are sure to exert more pressure on moms and dads who already feel under the gun.
Barb Love, mother of 15-month-old twins Mackenzie and Cole, said being a new parent can be overwhelming, especially with more than one baby.
"They are so tired and you literally go hour to hour," said the Toronto mom, who is also a nurse. "The last thing you think about is immunizations. I was thankful my physician was on top of things."
Alison Korn, mother of 23-month-old twins Daniel and Clara, said she was lucky to get a great pediatrician who has helped to get them on track.
"She tells us when to come in and what is on the agenda, so we haven't missed an appointment. We lean on our pediatrician to keep with the program."
The study deliberately excluded 5 per cent of Ontario children — 5,044 kids — who received no vaccinations at all by age 2. They were not included because their immunization status likely reflects parental preference rather than health-care service.
There's no systemic way of collecting vaccination rates in Toronto, outside of school-aged children and those in daycares. Toronto Public Health asks all parents to send the health unit information on their children's vaccination; call 416-392-1250 for information.


Miss Ash said...

One would think that this would be an important thing to keep track of. Apparently some parents don't care if their kids get polio. Interesting.....

Jennifer said...

I'm surprised the doctor doesn't keep track of it. And I don't see why more frequent visits to the doc would cure the problem. Why don't they have a sheet stapled to the inside of the file with a checklist, then when the doc gives a shot they tick it off and every time the kid comes in they can take a quick glance and see where the kid is in their shots.
Or computer tracking like at the dentist, where the computer tells he receptionist when to call and make an appointment with you.
I know it should be the parents responsability, but it's much easier for the doctor to do it, since it's a daily process for them.
Our doc was pretty good, but my mom also carried a card in her purse till I was about 17 with my immunization record on it, so that she could make sure it all got done.

Princess Pessimism said...

Luckily, when I ripped my arm open in december, they gave me my tetnus, and checked to make sure I was updated in all shots. I was. horray.

Trib said...

The clinic I used to work at had a checklist just like you said, jennifer. If the doctor doesn't slow down and make it a priority, though, even that doesn't matter. They're doing some preliminary studies here on pay for performance in which people who cross all their ts and dot their is will get a bonus. Money is a potent motivator.

Trib said...

And "SNAP" is right!

Jennifer said...

In Ontario they could just up the fee paid to doctors for each shot given out. They'd be more gungho to do it if it was increasing their profit margins.
It used to be that you could go to the doctor and have excess wax cleaned out of your ears, you know with an ear syringe and warm liquid and a kidney shaped bowl to catch the gross mess. Anyway, someone I knew went in more recently and asked the doctor to do that for him and the doctor said - you know, it's not good for your ears, and it's gross for me and I only get 9$ to do it, so I'm going to say no, if it's that important to you you can go to another doctor to get it done....
Money talks. He's right though, that's gross. I wouldn't want to do it either, maybe I'd think it was kind of neat to see what kind of stuff comes out of people's ears, but the novelty would probably wear off pretty quick.