Perceived barriers to childhood immunization: a physician and parent survey in a southeastern urban/rural community.
OBJECTIVE
To identify physicians' and parents' perceptions of barriers to completing the immunization process by age 24 months.


METHODS
A questionnaire hand-delivered to 110 physicians who treat children yielded a response rate of 83%. A telephone survey conducted with parents of a random sample of 2,100 children younger than three years of age selected from the county birth records yielded an adjusted response rate of 87%.


RESULTS
Physicians' response fell into two categories: those with more and less than 90% up-to-date immunizations. Those with less than 90% indicated that parental knowledge is the primary reason. Those with more than 90% reported telephone follow-up for missed appointments. The top three barriers reported by parents; (1) waiting time at the clinic (33%), (2) child too ill at time of appointment (21%), and (3) insurance does not cover immunizations (16%).


CONCLUSIONS
There is an opportunity for education intervention with physicians, policy makers, and parents in several key areas: (1) fact-based contraindications to immunizations, (2) effective means of follow-up, (3) accessibility to immunization for the under-insured, and (4) parental responsibility.
Nace
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Health Promotion Division, Metropolitan Health Department, Nashville, TN 37203, USA.
Larson
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C
Lester
T
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Kosinski
J
J
D002675:Child, Preschool; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D017589:Immunization Programs / Q000458:organization & administration*; D010290:Parents; D010818:Practice Patterns, Physicians'; D013714:Tennessee