Immunisation state and its documentation in hospital patients.

M J Ferson

Department of Microbiology, Prince of Wales Hospital, Randwick, New South Wales, Australia.

Two prospective surveys of the immunisation state and its documentation were conducted among children under 2 years old attending a children's hospital. A survey of 111 children attending the casualty or outpatient departments showed that, according to reliable records, 106 (95%) were fully immunised for age with oral polio vaccine, 93 (84%) with triple antigen, and 26 of 33 children greater than or equal to 16 months of age (79%) with measles-mumps vaccine. A survey of 204 inpatients showed that, according to verified records, significantly fewer inpatients than outpatients were fully immunised for age with oral polio vaccine (176, 86%) and with triple antigen (144, 71%). The proportion of inpatients vaccinated with measles-mumps vaccine was 81% (48 of 59). The inpatient figures are all lower than the 95% goal of current child immunisation programmes. Although parents of 98% of inpatients had a personal health record for the child, it was available at the time of admission for less than half the children. Lack of use of the personal health record by admitting medical staff was reflected in incorrect or absent documentation of the immunisation state in 17 of 49 (35%) of the records of children verified to have inadequate immunisations. Parents and health care staff need to be educated in the optimal use of the personal health record. Hospital paediatric staff need to be encouraged to verify the immunisation state of all young children, on admission, and arrange to rectify any deficiency found.

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