The Centralized Reminder Or Recall For Immunizations


My PICOT question aimed to determine if children between 2 and 24 months of age had higher immunization rates when their parents were reminded about the vaccination schedule compared to those who were not notified. The article titled “Supporting and sustaining centralized reminder/recall for immunizations: Qualitative insights from stakeholders” was chosen for this PICOT question. This qualitative study focused on the reminder system for parents and caregivers thar notifies them about the immunization schedule for their children; thus, it was in line with my project’s objectives. It was published in the Vaccine journal in 2019 by Fisher et al. All authors were qualified to conduct this research since they were professionals in the field of pediatrics. This report aims to discuss the strengths, limitations, and potential application of the selected paper. Overall, although the results of this study are not generalizable to all immunization information system (IIS) organizations, it provided essential data on the factors instrumental to the centralized reminder/recall (CRR) success.

Description of the Purpose

The objective of this research was to understand various forces that influence the outcomes of the CRR system. Specifically, the researchers studied the factors that influence the CRR system to understand the barriers and find the facilitating components for the purpose of improving immunization rates in the U.S. population (Fisher et al., 2019). Furthermore, the authors only focused on the perspective of those who operate this initiative.

Explanation of Research Design

The researchers performed this study in the form of semi-structured interviews through phone calls with either manager of IIS or representatives of the non-IIS organization. The authors used the qualitative content analysis method to assess the answers provided by the stakeholders during the 30-60 minutes interviews (Fisher et al., 2019). All calls were recorded and later transcribed to upload to the ATLAS software that performed the qualitative analysis of the responses.

Discussion of Sample

The sample population for this study was relatively diverse since the participants were the representatives of IIS organizations and non-IIS institutions or companies. The latter included public health organizations, health care plan providers, pharmaceutical corporations, and accountable care organizations (Fisher et al., 2019). Notably, only one manager from each IIS was invited for the interview, while several individuals from non-IIS groups involved in CRR somehow were allowed to participate.

Description of Data Collection Methods

Data was collected from the phone interviews with the study participants. The respondents were asked to provide information on their involvement in CRR, barriers, cost, effectiveness, and evaluation techniques of this program (Fisher et al., 2019). The calls were recorded, transcribed, and inserted into the content analysis tool. The authors properly coded all interviews to maintain personal data privacy and simplify the assessment process in the software.

Summary of Findings

This study found that such factors as funding, stakeholders’ attitude, partnerships, technology, decision-making, evaluation, and reminding messages’ content played a crucial role in the successful outcomes of CRR. Indeed, the importance of external collaborations and funding was critical for CRR since many IIS organizations discontinued this program because of a lack of finances (Fisher et al., 2019). Furthermore, representatives of IIS institutions mentioned that advanced technology and up-to-date software are crucial to avoid the glitch in the vaccination reminder system (Fisher et al., 2019). The authors highlighted that the participants described an overall positive view of the notification messages about immunization among caregivers (Fisher et al., 2019). However, the occasional negativity was noticed if reminders were wordy and lengthy or were sent multiple times, the latter occurring due to the outdated software (Fisher et al., 2019). Still, the CRR system seems to work because American children and adolescents’ vaccination rates are relatively high, according to the data from IIS.

Strengths of the Study

The primary strengths of this study are the wide variety of interviewees and a significant number of IIS organizations across the United States. Indeed, the researchers conducted semi-structured interviews via phone calls with managers working in IISs and non-IIS stakeholders such as clinicians, pharmaceutical companies, politicians, and health insurance firms (Fisher et al., 2019). Another strength is that the authors interviewed 23 organizations across the U.S., which allowed them to generate an overview of different factors critical for the success of the vaccination notification system (Fisher et al., 2019). The identified factors ranged from message content and stakeholder support to funding and technology.

Limitations of the Study

Despite a well-organized methodologic part, this study possessed three limitations. Firstly, the results of this research are not generalizable and can only be applied to IIS organizations that conduct CRR (Fisher et al., 2019). Secondly, the study did not include patients and caregivers in the interview process, which was a significant shortcoming because these two groups are essential stakeholders in terms of vaccination (Fisher et al., 2019). Thirdly, the authors could schedule only one interview per participant, which in most cases was the only representative of an entire organization.

Recommendations for Potential Application

The results of this article can be applied in future studies and even policies aimed at improving the immunization rate among children. This research showed that the support of CRR among the target population seems to be good according to the assessment and perception of the IIS organizations’ managers and non-IIS stakeholders like physicians and pharmaceutical companies. Future studies can use this data to determine the satisfaction rates with CRR among the general public. Moreover, policymakers can use these results to allocate a budget for upgrading data-collecting and reminder-sending technology in IIS centers. Another possible application is to adopt the same notification system in health care institutions to remind parents and caregivers living in the areas not covered by the IIS about the upcoming vaccinations for their children.


In summary, this report presented an overview of the article that aimed to determine factors contributing to better response to vaccination reminders and adherence to the immunization schedule. This paper was chosen based on my PICOT questions about the effectiveness of notifications to parents about their children’s upcoming vaccine shots. The analysis of the study showed that it is qualitative research of exceptional quality done by experts in the field of pediatrics. It was organized in the form of semi-structured interviews conducted via phone calls. The participants had diverse backgrounds, including representatives of immunization information system organizations and non-IIS institutions. It was found that the success of the centralized reminders/recalls depended on multiple factors like funding, technology, evaluation, and stakeholders’ acceptance of the system. Overall, although this research had some limitations, the authors were able to demonstrate that the CRR program is generally effective at ensuring that parents bring their children for immunization.


Fisher, M. P., Gurfinkel, D., Szilagyi, P. G., Saville, A., Albertin, C., Breck, A., Valderrama, R., & Kempe, A. (2019). Supporting and sustaining centralized reminder/recall for immunizations: Qualitative insights from stakeholders. Vaccine, 37(44), 6601-6608.