22803 School-Based Immunization Programs: Do Parental Preferences Predict Behavior?

Tuesday, April 20, 2010
Grand Hall
Amy Middleman, MD, MPH, MSEd , Associate Professor, Baylor College of Medicine

Background: Little is known about parental attitudes regarding school-based immunization programs (SBPs) and their effect on immunization behaviors.

Objectives: To determine the relationship between attitudes of middle school parents regarding school-based immunization and behaviors when a SBP becomes available.

Methods: In Fall, 2008, primarily Hispanic, middle school parents completed questionnaires about SBPs. After questionnaire collection, immunization consent/refusal packets (English/Spanish) for a SBP providing Tdap and MCV4 vaccines were distributed at five Houston middle schools in low-income, urban areas.  Responses regarding demographics, enrollment in a medical home, immunization location preferences, and knowledge of immunization recommendations were analyzed from those who later returned consent or refusal forms. Frequency and chi square statistics were calculated using SPSS 17.0.

Results: Of 465 parents who completed the questionnaire and later sent a consent or refusal form, 283 consented to ≥1 vaccines for their child. 87% identified as Hispanic, 11% black, 2% white; 37% spoke primarily English at home. Among those who consented, only 36% had responded “yes” when previously asked, “Are doctors recommending vaccines for 11-12 year olds?”; 71% indicated their child had a medical home; 43% indicated that they did NOT prefer SBPs; and 33% stated that they wanted to be present for their child’s shots. Those who sent a refusal form were not demographically different yet were significantly more likely to have knowledge of the recommendation, have a medical home and NOT prefer SBPs.

Conclusions: A significant proportion of Hispanic, low-income middle school parents consenting to participate in a SBP indicate a lack of knowledge of vaccine recommendations, availability of a medical home, a lack of preference for SBPs, and the desire to be present during their child’s injections when asked prior to program availability. Preferences noted in pre-program questionnaires may not predict parental consent behaviors for school-based immunizations.

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