BACKGROUND:
Public immunization clinics in Los Angeles County (LAC) are primarily designed to provide services to individuals with no other options for care. Studies were conducted in 1999 and 2003 to ascertain the characteristics of individuals seeking immunizations from the same public clinics.

OBJECTIVE:
To ascertain the barriers to immunizations and reasons individuals utilize public immunization clinics over time.

METHOD:
One interviewer-administered questionnaire was delivered per family to an adult accompanying a minor for immunization services at an LAC public health clinic. Survey topics included insurance coverage and barriers to accessing immunizations in the private sector.

RESULT:
“Close to home/easy transportation” was the primary reason for clinic selection in both surveys, regardless of insurance status (2003 Insured/Uninsured: 30.7%/31.1%; 1999 Insured/Uninsured: 31.5%/34.2%). Among uninsured respondents in 2003, “clinic-specific amenities” (25.2%) slightly outranked “cost and insurance” (23.4%) as the second reason for clinic selection. Asian/Pacific Islander, Hispanic, and White respondents with government assistance increased over 90% from 1999 to 2003. Among these same respondents, every race group’s knowledge of the immunization services covered by their insurance decreased between the two surveys. Among insured respondents in 2003, their primary alternative location for immunizations, if the current public clinic were closed, was not the private doctor/HMO as their counterparts in 1999 indicated, but rather another county/community clinic (34.2%). A large proportion of insured (2003: 23.5%; 1999: 13.7%) and uninsured (2003: 27.8%; 1999: 34.3%) respondents in both surveys did not know where they would take their children for immunizations in the event of such a clinic closure.

CONCLUSION:
Public clinics are still utilized by many children who could receive immunizations in the private sector. If public clinics were closed, a large proportion of clients would not know where to receive immunizations.

LEARNING OBJECTIVES:
To identify 2 barriers to accessing immunization services in the private sector.