Department of Pediatrics, School of Medicine
Seattle Children's Research Institute, Seattle, Washington.
Hosp Pediatr. 2021 Oct;11(10):1137-1152. doi: 10.1542/hpeds.2020-004655.
Many children are undervaccinated at the time of hospital admission. Our objective was to explore the facilitators and barriers to vaccinating during hospitalization.
We conducted qualitative interviews of parents, primary care pediatricians, emergency department (ED) physicians, and pediatric hospitalists. Parents of undervaccinated hospitalized children who were admitted through the ED were invited to participate. We used purposive sampling to identify physician participants. Semistructured interviews querying participants' perspectives on hospital-based vaccination were audiorecorded and transcribed. Parent demographics and physician practice characteristics were collected. Transcripts were analyzed for facilitators and barriers to vaccinating during acute hospital visits by using inductive content analysis. A conceptual framework was developed on the basis of the social ecological model.
Twenty-one parent interviews and 10 physician interviews were conducted. Of parent participants, 86% were female; 76% were white. Physician participants included 3 primary care pediatricians, 3 ED physicians, and 4 hospitalists. Facilitators and barriers fell under 4 major themes: (1) systems-level factors, (2) physician-level factors, (3) parent-provider interactional factors, and (4) parent- and child-level factors. Parent participants reported a willingness to receive vaccines during hospitalizations, which aligned with physician participants' experiences. Another key facilitator identified by parent and physician participants was the availability of shared immunization data. Identified by parent and physician participants included the availability of shared immunization data. Barriers included being unaware that the child was vaccine-eligible, parental beliefs against vaccination, and ED and inpatient physicians' perceived lack of skills to effectively communicate with vaccine-hesitant parents.
Parents and physicians identified several key facilitators and barriers to vaccinating during hospitalization. Efforts to provide inpatient vaccines need to address existing barriers.
许多儿童在住院时疫苗接种不足。我们的目的是探讨在住院期间接种疫苗的促进因素和障碍。
我们对父母、初级保健儿科医生、急诊部（ED）医生和儿科医院医生进行了定性访谈。邀请未接种疫苗的住院儿童的父母参加。我们采用目的性抽样来确定医生参与者。使用半结构化访谈询问参与者对医院疫苗接种的看法，并对访谈进行录音和转录。收集了父母的人口统计学资料和医生的实践特征。使用归纳内容分析对急性住院就诊期间接种疫苗的促进因素和障碍进行分析。根据社会生态模式，制定了一个概念框架。
进行了 21 次父母访谈和 10 次医生访谈。父母参与者中，86%为女性；76%为白人。医生参与者包括 3 名初级保健儿科医生、3 名 ED 医生和 4 名医院医生。促进因素和障碍属于以下 4 个主要主题：（1）系统层面的因素；（2）医生层面的因素；（3）父母-提供者互动因素；（4）父母和孩子层面的因素。父母参与者报告愿意在住院期间接种疫苗，这与医生参与者的经验一致。父母和医生参与者还确定了另一个关键的促进因素，即共享免疫数据的可用性。父母和医生参与者认为存在的障碍包括不知道孩子有资格接种疫苗、父母对疫苗接种的看法以及 ED 和住院医生认为缺乏与持怀疑态度的父母有效沟通的技能。
父母和医生确定了在住院期间接种疫苗的几个关键促进因素和障碍。为了提供住院疫苗接种，需要解决现有的障碍。
