Department of Pediatrics, Faculty of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta T3B 6A8, Canada.
BMC Pediatr. 2014 Jan 4;14:1. doi: 10.1186/1471-2431-14-1.
Accurate classification of children's immunization status is essential for clinical care, administration and evaluation of immunization programs, and vaccine program research. Computerized immunization registries have been proposed as a valuable alternative to provider paper records or parent report, but there is a need to better understand the challenges associated with their use. This study assessed the accuracy of immunization status classification in an immunization registry as compared to parent report and determined the number and type of errors occurring in both sources.
This study was a sub-analysis of a larger study which compared the characteristics of children whose immunizations were up to date (UTD) at two years as compared to those not UTD. Children's immunization status was initially determined from a population-based immunization registry, and then compared to parent report of immunization status, as reported in a postal survey. Discrepancies between the two sources were adjudicated by review of immunization providers' hard-copy clinic records. Descriptive analyses included calculating proportions and confidence intervals for errors in classification and reporting of the type and frequency of errors.
Among the 461 survey respondents, there were 60 discrepancies in immunization status. The majority of errors were due to parent report (n = 44), but the registry was not without fault (n = 16). Parents tended to erroneously report their child as UTD, whereas the registry was more likely to wrongly classify children as not UTD. Reasons for registry errors included failure to account for varicella disease history, variable number of doses required due to age at series initiation, and doses administered out of the region.
These results confirm that parent report is often flawed, but also identify that registries are prone to misclassification of immunization status. Immunization program administrators and researchers need to institute measures to identify and reduce misclassification, in order for registries to play an effective role in the control of vaccine-preventable disease.
准确分类儿童的免疫状况对于临床护理、免疫计划管理和评估以及疫苗计划研究至关重要。计算机化的免疫登记系统已被提议作为提供者纸质记录或家长报告的有价值的替代方案，但需要更好地了解与之相关的挑战。本研究评估了免疫登记系统中免疫状况分类的准确性与家长报告相比，并确定了两种来源中发生的错误的数量和类型。
本研究是一项对比较儿童免疫接种是否及时（UTD）与未及时（UTD）的两年特征的更大研究的子分析。儿童的免疫状况最初是从基于人群的免疫登记系统确定的，然后与邮政调查中报告的家长报告的免疫状况进行比较。两个来源之间的差异通过审查免疫提供者的纸质诊所记录进行裁决。描述性分析包括计算分类错误和报告错误类型和频率的比例和置信区间。
在 461 名调查受访者中，免疫状况有 60 处差异。大多数错误是由于家长报告（n = 44），但登记系统也并非没有错误（n = 16）。父母往往错误地报告他们的孩子为 UTD，而登记系统更有可能错误地将孩子归类为未 UTD。登记系统错误的原因包括未能记录水痘病史、由于起始年龄而导致所需剂量的变化以及在区域外接种的剂量。
这些结果证实，家长报告往往存在缺陷，但也表明登记系统容易对免疫状况进行错误分类。免疫计划管理员和研究人员需要采取措施识别和减少错误分类，以便登记系统在控制疫苗可预防疾病方面发挥有效作用。
