Goldstein K P, Kviz F J, Daum R S
Department of Pediatrics, University of Chicago, IL.
JAMA. 1993 Nov 10;270(18):2190-4.
Because some have advocated the use of emergency departments to administer delayed childhood immunizations, we evaluated the accuracy of immunization histories obtained in this setting by comparison with medical records of inner-city health care facilities.
Questionnaires were orally administered to adults accompanying children to the emergency department. Individual medical records were reviewed.
Pediatric emergency department at Wyler Children's Hospital, University of Chicago and 68 inner-city primary care clinics.
Children aged 3 to 65 months registering for medical care. Of the sample, 98% were African American; 75% were Medicaid recipients.
Adults' knowledge of immunization histories, immunization cards, and medical records compared with American Academy of Pediatrics/Immunization Practices Advisory Committee recommendations.
Of the accompanying adults, 64% stated that their child's general immunization status was "up-to-date"; 65% of these had clinic records confirming that status. Only 8% of specific regimens stated by these adults accurately matched those found in clinic records. Moreover, 45% of adults accompanying children at least 16 months and older provided inaccurate information regarding previous receipt of measles immunization.
Information provided by accompanying adults (from recall or from immunization cards) is inadequate to determine accurately which preschoolers in the pediatric emergency department are delayed in immunizations.
由于一些人主张利用急诊科来进行延迟的儿童免疫接种，我们通过与市中心医疗保健机构的病历进行比较，评估了在这种情况下获取的免疫接种史的准确性。
对陪同儿童前往急诊科的成人进行口头问卷调查。并查阅个人病历。
芝加哥大学怀勒儿童医院的儿科急诊科和68家市中心初级保健诊所。
登记接受医疗护理的3至65个月大的儿童。样本中98%为非裔美国人；75%接受医疗补助。
将成人对免疫接种史、免疫接种卡和病历的了解情况与美国儿科学会/免疫实践咨询委员会的建议进行比较。
在陪同的成人中，64%表示其孩子的总体免疫接种状况“最新”；其中65%有诊所记录证实该状况。这些成人陈述的特定免疫接种方案中，只有8%与诊所记录中的准确匹配。此外，在陪同至少16个月及以上儿童的成人中，45%提供了关于既往麻疹免疫接种情况的不准确信息。
陪同成人提供的信息（来自回忆或免疫接种卡）不足以准确确定儿科急诊科中哪些学龄前儿童免疫接种延迟。
