Childhood vaccine risk/benefit communication among public health clinics: a time-motion study

Public Health Nurs. May-Jun 2004;21(3):228-36. doi: 10.1111/j.0737-1209.2004.021305.x.


United States law requires that immunization providers use Centers for Disease Control Vaccine Information Statements (VISs) and inform parents about vaccine risks and benefits prior to every childhood immunization. A recent national survey found that public health clinics (PHCs) reported high compliance with this law. To further investigate these findings, we conducted an immunization time-motion study in two PHCs in Kansas and Louisiana. Research assistants observed a convenience sample of 246 child immunization visits to record distribution of the VISs and content and time of vaccine communication. Thirty percent of parents read below a ninth grade level, 53% had Medicaid insurance, and 56% were Black. VISs were given with every dose of vaccine administered in 89% of visits. Public health nurses (PHNs) frequently discussed potential vaccine side effects (91%), treatment of side effects (91%), and the vaccine schedule (93%). Contraindications were screened in 71% of visits. Benefits were discussed in 48% of visits and severe risks in 29%. The national Vaccine Injury Compensation Program (VICP) was never discussed. The immunization visits lasted for a mean of 20 min. Vaccine communication of side effects, risks, benefits, screening for contraindications, and the next visit lasted for an average of 16 s for all vaccines. PHC compliance with mandated VIS distribution and practical vaccine communication was high. Room for improvement exists in discussion of benefits, serious risks, and the VICP.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Ambulatory Care Facilities / statistics & numerical data*
  • Child, Preschool
  • Educational Status
  • Female
  • Health Education / legislation & jurisprudence
  • Health Education / statistics & numerical data*
  • Humans
  • Infant
  • Kansas
  • Louisiana
  • Male
  • Mass Vaccination / nursing*
  • Mass Vaccination / statistics & numerical data*
  • Patient Participation
  • Patient Satisfaction
  • Professional-Family Relations
  • Public Health Nursing / methods
  • Public Health Nursing / statistics & numerical data*
  • Risk Assessment
  • Time and Motion Studies