Follow-up of MMR Vaccination Status in Children Referred to a Pediatric Immunization Clinic on Account of Egg Allergy

Aim: To determine timeliness and completeness of MMR immunisation uptake and general immunisation status of egg-allergic children referred to hospital for MMR vaccine who were referred back to their primary care providers with explanatory information that community-based vaccination is safe in these children. Method: Referred children’s immunisation status obtained from referring practices. Where the practice had no record parents were contacted. Parents whose children had not received MMR were asked reasons for their choice. Timeliness of immunisations was examined for both MMR and the primary schedule. Practices referring more than one child to immunisation clinic were analysed to determine whether previous letters from the immunisation clinic influenced their referring practice. Results: 82 children were eligible from 67 practices. MMR status was obtained for 78 (95% response rate). Of these 78, 73 (94%) received MMR vaccination with no reported adverse events: 8 (11%) on time, 54 (69%) late and 11 (14%) timeliness unknown. Five (6%) children had not received MMR vaccination. Three practices were unwilling to carry out MMR immunisation of egg-allergic children, even after recommendation from the immunisation clinic. Of the five parents whose children had not received MMR, two had actively decided against vaccination. Discussion: 94% children received their MMR in primary care with no reported adverse effects. The current strategy utilised by the immunisation clinic appears to result in MMR immunisation of egg-allergic children. While the referral process may result in delayed immunisations, continued education of health professionals may improve timeliness and immunisation rates.

[1]  F. Goodyear-Smith,et al.  Family practice nurse views on barriers to immunising children. , 2005, Vaccine.

[2]  J. Giesecke,et al.  Timeliness of MMR vaccination--influence on vaccination coverage. , 2004, Vaccine.

[3]  F. Goodyear-Smith,et al.  Family physician perspectives on barriers to childhood immunisation. , 2004, Vaccine.

[4]  J. Kelso,et al.  Immunization of egg-allergic individuals with egg- or chicken-derived vaccines. , 2003, Immunology and allergy clinics of North America.

[5]  G. Lack,et al.  Egg allergy and MMR vaccination. , 2003, The British journal of general practice : the journal of the Royal College of General Practitioners.

[6]  B. Niggemann,et al.  A practical approach to immunization in atopic children , 2002, Allergy.

[7]  G. Lack,et al.  Recommendations for using MMR vaccine in children allergic to eggs , 2000, BMJ : British Medical Journal.

[8]  A. Finn,et al.  MMR vaccine and allergy , 2000, Archives of disease in childhood.

[9]  R. Zimmerman,et al.  Are vaccination rates higher if providers receive free vaccines and follow contraindication guidelines? , 1999, Family medicine.

[10]  P. Szilagyi,et al.  Barriers to immunization and missed opportunities. , 1998, Pediatric annals.

[11]  R. Andrews,et al.  Vaccinating children with a history of serious reactions after vaccination or of egg allergy , 1998, The Medical journal of Australia.

[12]  C. Siegrist Vaccination strategies for children with specific medical conditions: a paediatrician's viewpoint , 1997, European Journal of Pediatrics.

[13]  D. Baxter Measles immunization in children with a history of egg allergy. , 1996, Vaccine.

[14]  P. Roberson,et al.  Safe administration of the measles vaccine to children allergic to eggs. , 1995, The New England journal of medicine.

[15]  R. Aickin,et al.  Measles immunisation in children with allergy to egg , 1994, BMJ.

[16]  P. Giampietro,et al.  Safety of measles immunisation in children with IgE-mediated egg allergy , 1990, The Lancet.

[17]  E. Meltzer,et al.  The safety of egg-containing vaccines for egg-allergic patients. , 1983, The Journal of allergy and clinical immunology.