Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Leslie Scott

Clinical Mentor

Dr. Shawn Reathaford

Committee Member

Dr. Dianna Inman


Childhood immunizations protect children from life-threatening illnesses and are one of the most profound measures of the quality of pediatric primary care, however immunization rates for children under three years old still fall below national goals for up to date coverage. In addition to preventing children from getting serious illnesses, childhood vaccines prevent 21 million hospital visits, prevent 732,000 deaths, and save 1.38 trillion dollars in societal costs. Despite the many benefits of vaccines and the national recommendations, nearly 25% of children ages 19-35 months fall short of receiving all recommended vaccines. Kentucky demonstrates vaccination rates below the national average for the poliovirus, MMR, and PVC vaccines. In examining the reasons for underimmunization in children, both parent factors and provider factors come into play. Provider factors that attribute to underimmunization are a problem because it is the responsibility of the pediatric primary care provider to ensure full immunization coverage for the health of the child. The main component of provider practices that lead to underimmunization in children is missed opportunities for vaccination during visits. To obtain more information about provider missed opportunities for immunization a survey was developed and sent to providers in the state of Kentucky. The survey was created to gain information about provider practices regarding tracking immunizations and to attempt to identify trends among practices and immunization rates.