Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance

INTRODUCTION Childhood vaccination has proven to be one of the most effective public health strategies to control and prevent disease.1–7 In an effort to reduce childhood morbidity and mortality, the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) issues annual recommendations and guidelines for childhood and adolescent immunizations.3,8–10 However, some parents decline or delay vaccinating their children or follow alternative immunization schedules because of medical, religious, philosophical, or socioeconomic reasons.3,4,6,7,9,11–16 Health care provider-based interventions have been suggested to overcome such vaccine noncompliance, including patient counseling; improving access to vaccinations; maximizing patient office visits; offering combination vaccines; and using electronic medical records (EMRs) and practice alerts.3,4,6,9,12,14 Communityand government-based interventions to improve parent and patient adherence include public education and reminder/recall strategies, financial incentives, and providing alternative venues for vaccination.3,9