Age-Specific Strategies for Immunization Reminders and Recalls

American Journal of Preventive Medicine
Volume 47, Issue 1, p1-104, e1-e2 July 2014

Age-Specific Strategies for Immunization Reminders and Recalls
A Registry-Based Randomized Trial
Kevin J. Dombkowski, DrPH, MS, Lauren E. Costello, MSW, Laura B. Harrington, MPH, Shiming Dong, MS, Maureen Kolasa, MPH, BSN, Sarah J. Clark, MPH
Published Online: April 18, 2014
This activity is available for CME credit. See page A3 for information.
Although previous studies have found reminder/recall to be effective in increasing immunization rates, little guidance exists regarding the specific ages at which it is optimal to send reminder/recall notices.
To assess the relative effectiveness of centralized reminder/recall strategies targeting age-specific vaccination milestones among children in urban areas during June 2008–June 2009.
Three reminder/recall strategies used capabilities of the Michigan Care Improvement Registry (MCIR), a statewide immunization information system: a 7-month recall strategy, a 12-month reminder strategy, and a 19-month recall strategy. Eligible children were randomized to notification (intervention) or no notification groups (control). Primary study outcomes included MCIR-recorded immunization activity (administration of ≥1 new dose, entry of ≥1 historic dose, entry of immunization waiver) within 60 days following each notification cycle.
A total of 10,175 children were included: 2,072 for the 7-month recall, 3,502 for the 12-month reminder, and 4,601 for the 19-month recall. Immunization activity was similar between notification versus no notification groups at both 7 and 12 months. Significantly more 19-month-old children in the recall group (26%) had immunization activity compared to their counterparts who did not receive a recall notification (19%).
Although recall notifications can positively affect immunization activity, the effect may vary by targeted age group. Many 7- and 12-month-olds had immunization activity following reminder/recall; however, levels of activity were similar irrespective of notification, suggesting that these groups were likely to receive medical care or immunization services without prompting.