Immunization histories given by adult caregivers accompanying children 3-36 months to the emergency department: are their histories valid for the Haemophilus influenzae B and pneumococcal vaccines?
OBJECTIVE
To obtain immunization histories from adult caregivers accompanying children to the emergency department (ED), to determine the accuracy of the caregiver's report for the Haemophilus influenzae B (Hib)and 7-valent pneumococcal vaccine (PCV7).


METHODS
This was a prospective, observational study of children age 3 to 36 months presenting to the Albert Einstein Medical Center ED during the period of November 1, 2004, through January 31, 2005. Caregivers were asked to complete a questionnaire about their child's immunization status and if the child's vaccinations were up-to-date. Immunization records were obtained from the child's most recent primary care physician (PCP) to determine whether the caregiver's report was correct for PCV7 and Hib. Children were considered delayed if they were more than 30 days past due date for one or both vaccines according to the PCP records.


RESULTS
Of 205 PCP offices contacted, we were able to obtain 173 immunization records for our analysis. Examination of vaccine records showed that 109 (63.0%) of the 173 children were up-to-date on both immunizations. When the child's caregiver was asked if shots were up-to-date, 159 (91.9%) of 173 said that all shots were given, and only 14 (8.1%) of 173 reported being behind schedule. Of the adults reporting the child up to date, 105 (66.0%) of the 159 children were confirmed to be up-to-date. Thus, 34.0% of caregivers were incorrect in stating that their child's immunization status was up-to-date for both these vaccines.


CONCLUSIONS
Caregiver report was determined to be inaccurate for Hib and PCV7. Despite 91.5% of caregivers stating that shots were up-to-date, only 66.0% were correct that their child was up-to-date with these 2 vaccines. The ED physician should use caution in making clinical decisions based on the history given by a caregiver regarding their child's immunization status.
Williams
Edwin R
ER
Department of Emergency Medicine and Division of Research, Albert Einstein Medical Center, Philadelphia, PA 19141, USA.
Meza
Yenney E
YE
Salazar
Sylvia
S
Dominici
Paul
P
Fasano
Charles J
CJ
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis; D017028:Caregivers / Q000523:psychology*; D002675:Child, Preschool; D003142:Communication; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D005334:Fever / Q000175:diagnosis / Q000209:etiology; D018073:Haemophilus Vaccines; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008487:Medical History Taking; D008583:Meningitis, Haemophilus / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control; D008586:Meningitis, Pneumococcal / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control; D011939:Mental Recall; D010290:Parents / Q000523:psychology; D015143:Philadelphia; D022242:Pneumococcal Vaccines; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data
D018073:Haemophilus Vaccines; D022242:Pneumococcal Vaccines