Washington State Licensed Child Care Facility Directors' Perspectives On Childhood Immunization

Background: In Washington State, the program director of a child care facility is responsible for educating enrolled parents about the importance of immunizations and monitoring the immunization information of enrolled children for accuracy and completeness. Given these responsibilities, child care facility directors in Washington State serve an important role in the immunization status of children in child care. No data, however, exist regarding child care facility directors’ compliance with these requirements and the impact of their own immunization attitudes and beliefs on their compliance.

Setting: Licensed child care facilities in Washington State.

Population: Program directors of Washington State licensed child care facilities included in the Washington State Department of Early Learning Licensed Child Care Provider List (N = 7446).

Project Description: We mailed a self-administered survey to 2000 child care facility directors randomly selected from the Washington State Department of Early Learning Licensed Child Care Provider List to assess their general perspectives on childhood vaccines and their immunization education and monitoring behavior.

Results/Lessons Learned: Our response rate was 28%. The majority of respondents worked at facilities with a licensed capacity of <25 children, had ≥11 years of experience, and were parents themselves. Overall, 67% agreed that they educated enrolled parents about the importance of immunizations and 90% agreed that they monitored the immunization status of enrolled children. However, 51% were concerned that any one of the childhood immunizations might not be safe, 25% felt children get more immunizations than are good for them, and 20% were unsure that following the recommended immunization schedule was a good idea. These beliefs were associated with a significantly decreased likelihood of educating parents about the importance of immunizations (adjusted Odds Ratios (aORs): .50, .56, and .21, respectively) and monitoring the immunization status of children (aORs: .44, .46, and .41, respectively).