KEYWORDS:
varicella; immunization; barriers

BACKGROUND:
The generally mild course of varicella infections has facilitated pervasive casual attitudes about this disease. A safe and effective vaccine against varicella has been available since 1995, however fears and misconceptions about the vaccine may continue to exist in the populations investigated in this study.

OBJECTIVE(S):
To elucidate various factors that may contribute to either offering or seeking timely varicella vaccination and to make recommendations addressing any barriers that are found.

METHOD(S):
An exploratory needs assessment was conducted by performing: (1) a medical chart audit at Northeast Valley Health Corporation; (2) a survey of providers at NEVHC; (3) a survey of parents of NEVHC pediatric patients. The questionnaires were comprised of knowledge, attitudinal and behavioral components that were designed to identify specific issues that may influence varicella immunization rates.

RESULT(S):
The medical chart audit revealed significantly different coverage levels among various age groups, ranging from 13% among 13- to 18-year-olds to 88% among 2- to 3-year-olds. Notably, adequate documentation of disease or vaccination status is an issue. Attitudinal results from the provider questionnaire revealed that the varicella vaccine is safe and effective and that a public health benefit exists to routinely vaccinate all susceptible children against chickenpox. Data from the patient questionnaire are currently being collected.

CONCLUSIONS(S):
The chart audit found a surprisingly high varicella vaccination coverage level among 2- to 3-year-olds at NEVHC. Additionally, the attitudes and practices of the practitioners do not appear to be significant barriers to young children receiving this vaccine on a timely basis. Data on the knowledge, attitudes and behavior of parents is pending.

LEARNING OBJECTIVES:
To identify two potential barriers associated with health care providers/parents in offering/obtaining the varicella vaccine.
To identify three changes that could be implemented in a clinic to improve varicella vaccination rates among pediatric patients.