Vaccine information statements in the pediatric office

A parent-driven, computer-based vaccine information system: addressing variability in information needs for the varicella vaccine

OBJECTIVE

To determine the variability of parental interest in the depth of detail provided regarding vaccine information.

PARTICIPANTS AND METHODS

We performed a cross-sectional, observational study in a primary care pediatric practice from September 1 to September 30, 1995. We provided each participant an opportunity to use a self-directed, computer-based information system using the varicella vaccine as a prototype. The system covered 7 topics regarding the vaccine and offered 5 stages of information, ranging from general, indisputable information at stage 1 to less common, potentially unresolved details at stage 5. Parents viewed stage 1 information for each topic. Parents would then choose to either view more stages or view the next topic.

RESULTS

Of 130 parents visiting the pediatric practice, 112 (86%) agreed to participate. We found substantial variability in the amount of information sought. Some parents stopped with stage 1 information (15%-45%, depending on the topic), whereas others indicated they would seek more information beyond the fifth stage (2%-14%). Overall, parents reported high satisfaction with the system.

CONCLUSION

Quantifiable variability exists in parents' requirements for vaccine information, and our information system addresses this issue.

The overall safety profile of currently available vaccines directed against infectious diseases

The vaccines currently used worldwide for the prevention of infectious diseases are quite safe in comparison to most pharmaceutical and biological agents. Vaccine components may contribute to inflammatory, allergic or anaphylactic reactions. Most adverse events are transient and well-tolerated. Transient severe adverse reactions occur at rates of one in one thousand vaccinations; permanent severe adverse reactions occur on the order of one in one million. The most common of the severe adverse reactions are syncope and allergic reactions. Providers can take steps to prevent or ameliorate these reactions by pursuing both prelicensure testing (albeit limited) and postlicensure testing and monitoring. Systems that enhance the detection of safety concerns include national passive and active surveillance as well as regional vaccine registries and provider-based patient education. Since vaccines are used in universal programmes, their safety is paramount to their continued acceptance. Healthcare managers, including administrators of hospitals, clinics, practice groups, health maintenance organisations (HMOs) and managed care plans, can and should support providers in minimising adverse events associated with vaccines by supporting postvaccination observation policies, postlicensure testing and surveillance, vaccine registries and patient education systems.