Sending reminders to parents to get their children vaccinated was more effective and cost-efficient when physicians collaborated with public health departments compared with practice-based notification efforts, a new study found.
The study appeared online Monday in JAMA Pediatrics. Vaccination rates around the country have come under increased focus in recent weeks in light of the current measles outbreak that has infected 154 people in 17 states between Jan. 1 and Feb. 20, according to the Centers for Disease Control and Prevention. A majority of cases have been linked to an outbreak that began in December at Disneyland in California, where most of those infected were reported to have not been vaccinated with the measles, mumps and rubella, or MMR, vaccine.
Researchers conducted a randomized trial involving more than 18,000 children from 15 Colorado counties where a share of households received either calls or mail reminders from the Colorado Immunization Information System, an information database run by the Colorado Department of Public Health and Environment that receives vaccination information from health providers and insurers. Other patients received reminders solely from primary-care physician practices, which were reimbursed for the phone calls and mailings.
Of those notified by CIIS, more than 7,800 out of more than 9,000 children received at least one contact compared with 75 children who were reached by physician practices because only two practices conducted reminders.
Among children who were reminded by CIIS, the rate of immunization for at least one vaccine was 27% compared with 22% of patients reminded by practices, according to the study. The rate of those found to be fully up to date with all seven of the vaccinations required before attending school was 13% among those contacted by CIIS, compared with 9% among those reminded solely by providers.
Using a collaborative approach was also found to be more cost-effective, according to the study. The total cost for reminding patients using CIIS was $28,620, or $11.75 per child to achieve one immunization and $24.72 to get them fully up-to-date. By comparison, the two practices who engaged in reminding patients to get immunized had costs that averaged $74 per patient for at least one vaccine and $124 per child to get them up-to-date with all required immunizations.
“Our findings and those of previous studies support consideration of a collaborative collective compared with a practice-based reminder/recall approach to increase immunization rates during the preschool years,” the study concluded. “Sustainable funding mechanisms will be needed to support such an approach and may involve a shared investment between practice organizations or accountable care organizations and the public sector. With minimal contributions from each, substantial cost savings should be realized from a societal perspective.”
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