title: Limitations of school entry immunization certificates.
abstract: OBJECTIVE
  To compare the immunization certificate submission rate for kindergarten school children on the Central Coast of New South Wales for 1994 and 1995; to contact individual parents of children with incomplete or missing immunization certificates by issuing a personalised immunization reminder letter, and measuring their response.
  
  
  METHODS
  Seventy Central Coast schools were surveyed. Immunization documentation for 4177 kindergarten enrolements in 1995 were assessed. Children with incomplete or unknown immunization status were identified. Immunization reminder letters were sent by the schools to parents of the children that were identified. The school recorded any additional immunization certificates submitted.
  
  
  RESULTS
  In 1995, 79% of kindergarten children submitted immunization certificates, unchanged from the previous year. Immunization reminder letters were sent to 856 families of children with no certificate and 215 families of children with an incomplete certificate. A further 263 immunization certificates were submitted, representing a 25% response rate. This intervention increased the percentage of kindergarten children with a certificate from 79% to 86%.
  
  
  CONCLUSIONS
  Education of school staff during the 1994 immunization survey did not change the overall immunization certificate submission rate. Specifically targeting parents through schools can be an effective way of increasing immunization certificate submission.
authors.affiliation: Central Coast Area Health Service, Gosford, New South Wales, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Miksevicius
authors.forename: P
authors.initials: P
authors.lastname: Johnson
authors.forename: P D
authors.initials: PD
authors.lastname: Watt
mesh_terms: D002675:Child, Preschool; D006306:Health Surveys; D006801:Humans; D007114:Immunization / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D009517:New South Wales; D010290:Parents; D017010:Reminder Systems; D012574:Schools