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May 1999

Impact of Community Volunteers on Immunization Rates of Children Younger Than 2 Years

Author Affiliations

From the School of Public Health, Center for Population and Family Health (Ms Barnes and Dr Brickner Namerow) and School of Nursing (Dr Honig), Columbia University; and the Bureau of Immunization, New York City Department of Health (Dr Friedman), New York, NY. Ms Barnes is now with the School of Health and Applied Sciences, Suffolk College, Ipswich, England.

Arch Pediatr Adolesc Med. 1999;153(5):518-524. doi:10.1001/archpedi.153.5.518

Objective  To assess the effectiveness of a volunteer-driven outreach program on immunization rates in children younger than 2 years.

Design  Randomized controlled trial.

Setting  Pediatric ambulatory clinics in New York, NY.

Patients  A total of 163 children were randomly assigned to receive services from the volunteer-driven outreach program or to serve as control subjects. All children were (1) younger than 2 years, (2) no-shows for a scheduled appointment in the pediatric clinic, and (3) due or overdue for a vaccine.

Intervention  Immunization outreach, tracking, and follow-up were provided by community volunteers throughout follow-up (mean, 6.5 months). Control children were notified of immunization status at enrollment but received no further contact until the conclusion of follow-up (mean, 6.4 months).

Main Outcome Measure  Immunization status 6 months after enrollment.

Results  Significantly more intervention children were up-to-date with their vaccination series than controls (75% vs 54%; P=.03). Children in the control group were 2.8 times more likely to be late for a vaccine than intervention children (odds ratio=2.8;P=.02). In addition, an immunization delay of longer than 30 days at enrollment was a significant predictor of final immunization delay (odds ratio=2.6;P=.02).

Conclusions  This volunteer-driven program significantly improved immunization rates among intervention children compared with controls. Results confirm previous findings that indicate an increased risk of an incomplete immunization series by 2 years of age among children who fall behind early in their primary vaccination series. However, control children were almost 3 times more likely to be late (for ≥1 vaccines) than intervention children, regardless of whether an earlier immunization delay was present.