Pediatric primary care immunization policies in New York State

• Published in: Vaccine 2022-03, Vol.40 (10), p.1458-1463
• Main Authors: Lillvis, Denise F., Miller, Connor R., Kuo, Dennis Z.
• Format: Article
• Language: English
• Subjects: Child; Children; Content analysis; Coronaviruses; Coverage; COVID-19; COVID-19 vaccines; Cross-Sectional Studies; Data analysis; Families & family life; Health care; Health Knowledge, Attitudes, Practice; Humans; Immunization; Infectious diseases; Measles; Medical personnel; New York; Pandemics; Parents; Parents & parenting; Pediatrics; Physicians; Policies; Policy; Practice management; Primary care; Primary Health Care; Public health; Qualitative analysis; Quality control; SARS-CoV-2; Schedules; Vaccination; Vaccine hesitancy; Vaccines; Websites
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2022.01.045

•Almost 40% of NY State practices have immunization policies for pediatric patients.•Formal policies require vaccination or have a consequence for not fully vaccinating.•Informal policies express support for childhood vaccination without a requirement.•Policies contain language that target specific reasons for vaccine hesitancy.•Majority-pediatrician practices are more likely to have immunization policies. Practice immunization policies may reflect how their physicians and nurses approach vaccine hesitant parents. This study utilized New York State primary care practices’ websites to locate immunization policies for pediatric patients and collect practice-level data. For this cross-sectional study, we extracted website data in February/March of 2019. We first conducted a qualitative content analysis using the policy text and developed definitions of practice policy types (i.e., formal, informal, or no policy). Two authors independently reviewed and coded the text, and employed consensus meetings and feedback from the third author to finalize the content analysis. We then examined associations between practice-level characteristics and immunization policy presence through categorical data analysis. Of the 254 practice websites identified, 36 referred to formal immunization policies that may include consequences (e.g., dismissal) for refusing to vaccinate or not fully vaccinating, and 64 referred to informal policy statements supporting immunization. Most (89%) policies included appeals to scientific and/or professional authority. Almost all (92%) contained language tailored to potential reasons for parents’ vaccine hesitancy. Our categorical analyses indicate that majority-pediatrician practices are associated with the presence of either formal or informal immunization policies (p