DATA POKES: June 2013

Staff Update- Adam Boyette

The Oregon Immunization Program (OIP) is pleased to announce the hiring of Adam Boyette as a research analyst. Adam recently finished a PhD in anthropology from Washington State University. His dissertation work focused on children’s social learning among hunting and gathering societies in Africa. Despite his Indiana Jones-like appearance, Adam professes little experience with dangerous relics and obscure temples. Instead his main area of academic focus was on how ideas and culture are transmitted between individuals. Adam believes in an ‘epidemiology of ideas’ to explain how ideas, like diseases, can spread.

Adam is replacing Scott Jeffries, whose new role in OIP is working on an adolescent immunization grant. Adam will be in charge of the Population-Based Rates program and other special projects. Adam is looking forward to applying his research experience to public health and immunizations in Oregon. He is also extremely excited to talk about the birth of his now month-old daughter, Delphine. (Baby pictures on request).

Staff Publications
Steve Robison. Sick visit immunizations and delayed well-baby visits. Pediatrics, June 3rd, 2013.

Sick visits is one of the hardest barriers to address when trying to keep kids on an immunization schedule. Many kids are likely to be sick during one or more of the periods when shots are due in early childhood, and having a sick visit when immunizations are due is a common reason for infants falling behind.

AAP/ACIP policy calls for giving immunizations on sick visits for mild or moderate illnesses such as otitis media (earaches), regardless of whether there is a fever or not. However some providers worry that giving due immunizations on sick visits may discourage further shot seeking, or discourage returning to make-up missed well-baby checks.

A new study by Steve Robison in Pediatrics looked at whether giving sick visit shots discouraged returning for make-up well baby visits or further immunization seeking. Using ALERT and DMAP data, this study found that giving sick visit shots was not a risk for lower immunization or well baby visit rates. In contrast over a third of those who did not get a sick visit immunization failed to return for a make-up visit, and had significantly lower immunization rates and lower numbers of well-baby visits by age two. So avoiding sick visit shots has little benefit and carries a risk of children falling behind and not catching up on immunizations.

As a take-away message, if a child presents sick when shots are due consider giving them their immunizations. If you can’t, make sure that the parent has a make-up appointment scheduled before they leave the clinic.

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