Effect of an educational intervention and parental vaccine refusal forms on childhood vaccination rates in a clinic with a large Somali population

Objective: The purpose of this study is to improve vaccination rates at a clinic with a large Somali population, and many vaccine hesitant parents. The study evaluated the effectiveness of some new materials for vaccine hesitant parents. Methods: Educational sessions were given to providers and staffto give "talking points" and to introduce a vaccine refusal form. Chart reviews were done for notes from 50 random well child visits per month of children less than six years old for 7 months before and after the intervention. Results: Before the intervention, 44% of Somali children who needed shots did not get them at their well child visit. Afterwards, 34% of the Somali children did not get their needed shots. Of non-Somali children, 16.8% did not get needed shots before the intervention, and 12.7% did not get needed shots after the intervention (P=0.07). The MMR was the most frequent vaccine omitted. After the intervention, 29 parents signed the vaccine refusal form. Conclusion: The "talking points" and vaccine refusal form were associated with improvements in immunization rates in this challenging patient population that were not statistically signifi- cant. Refusal form use was not well documented, so its true value requires further study.