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. 2021 Oct 1;37(10):e640-e644.
doi: 10.1097/PEC.0000000000001739.

Accuracy of Parental-Reported Tetanus Vaccination Status for Children With Lacerations

Zachary Drapkin, Troy E Madsen  1 , Nicholas Weaver  2 , Joyce V Soprano  3
Affiliations

Accuracy of Parental-Reported Tetanus Vaccination Status for Children With Lacerations

Zachary Drapkin et al. Pediatr Emerg Care. .

Abstract

Objectives: The aim of this study was to determine whether emergency department (ED) providers are able to accurately assess whether a child with a laceration needs tetanus prophylaxis.

Methods: We conducted an 8-month prospective cross-sectional study of children presenting with a laceration to a pediatric ED. We asked ED providers whether tetanus prophylaxis was necessary. An ED pharmacist accessed the Utah Statewide Immunization Information System (USIIS), and we assessed the accuracy of the ED provider's determination of necessary tetanus prophylaxis compared with USIIS records.

Results: Among 375 patients aged 5 months to 17 years, ED providers made an inaccurate assessment of necessary tetanus prophylaxis in 33 cases (8.8%; 95% confidence interval [CI], 6.3%-12.1%). Emergency department providers would have inappropriately administered tetanus prophylaxis in 5 cases (1.3%; 95% CI, 0.5%-3.2%) and would have missed the need for tetanus prophylaxis in 28 cases (7.5%; 95% CI, 5.2%-10.6%). Emergency department providers were more likely to provide an inaccurate recommendation in older children (8.3 vs 4.8 years; P < 0.001), in patients with a dirty wound (45.5% vs 11.7%; P < 0.001), and in children who had fewer than 3 vaccines recorded in the USIIS (54.5% vs 1.2%; P < 0.001).

Conclusions: Emergency department providers may inaccurately assess the need for tetanus prophylaxis in children. Special attention should be paid to cases of dirty wounds and cases in which fewer than 3 tetanus-containing vaccines have been given.

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Conflict of interest statement

Disclosure: T.E.M. is currently funded as a site principal investigator for a grant from Roche Diagnostics evaluating high-sensitivity troponin T in emergency department patients with chest pain. All other authors declare no conflict of interest.

References

    1. Centers for Disease Control and Prevention. Epidemiology and prevention of vaccine-preventable diseases. Washington, DC: Public Health Foundation. 2011;12.
    1. AbdelSalam HH, Sokal MM. Accuracy of parental reporting of immunization. Clin Pediatr (Phila) . 2004;43:83–85.
    1. Rossi PG, Faustini A, Spadea T, et al. Choosing immunisation coverage indicators at the local level. Eur J Epidemiol . 2004;19:979–985.
    1. Dorell CG, Jain N, Yankey D. Validity of parent-reported vaccination status for adolescents aged 13–17 years: National Immunization Survey—Teen, 2008. Public Health Rep . 2011;126(suppl 2):60–69.
    1. Suarez L, Simpson DM, Smith DR. Errors and correlates in parental recall of child immunizations: effects on vaccination coverage estimates. Pediatrics . 1997;99:E3.

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