Immunization Site Preferences among Primarily Hispanic Middle School Parents

Background:
To eliminate disparities in immunization rates among adolescents, more knowledge is needed regarding attitudes and preferences among populations at risk for decreased rates.

Objectives:
To examine immunization site preferences among middle school parents/guardians in primarily Hispanic, low-income areas.

Methods:
Approximately 7300 parent questionnaires were distributed at 8 middle schools. Middle schools were included based on % free lunch (94-97%). Frequency and chi-square statistics are reported for data from 719 of ~2200 expected forms.

Results:
91% of respondents are Hispanic, 5% Black, 2% white. 34% speak primarily English at home, 56% Spanish, 11% both. 79% report a medical home, with English speakers more likely to report having a medical home (92% vs 78%, p<0.0001). The child's last shot is reported at the medical home for 56%, city/county clinic for 25%, mobile clinic for 7%, school-based program (SBP) for 3%, pharmacy for 1%, ER for 0.1%. When asked for preferred immunization sites for their child, 66% indicate the medical home, 41% SBP, 33% city/county clinic, 14% mobile clinic, 6% each for ER and pharmacy. Of those not choosing SBP, 68% report that they “want to be present when my child gets shots.” Spanish speakers less likely to choose the medical home (p=0.001) and more likely to prefer city/county clinic (p<0.001) and SBPs (p=0.002). Finally, despite 86% reporting the child had a medical visit within 2 years, only 37% of 719 responded affirmatively to “Are doctors recommending vaccines for 11-12 year olds?”

Conclusions:
Among low-income, primarily Hispanic, middle school parents/guardians, knowledge of vaccine recommendations is low. Primary language at home is associated with immunization site preferences. Although interest in SBPs is high, most parents not choosing SBPs report wanting to be with their children when they receive shots, requiring creative solutions when implementing SBPs for vulnerable populations.