Gaps in Immunizing Children During Hospitalization: How Can We Close Them?
Bibliographic record
Abstract
In the Author's own words:Children are often under-vaccinated at the time of hospitalization.Hospitalized children experience many barriers to vaccination, including challenges accessing vaccines and caregiver concerns about vaccines, both for routine childhood vaccines and coronavirus disease 2019 (COVID-19) vaccines.In this issue of Hospital Pediatrics, 2 studies explored inpatient immunization and barriers to vaccine delivery during hospitalization.1,2 Lissinna et al assessed the immunization status of hospitalized children at their institution in Canada and explored caregiver barriers to and concerns about vaccination via the Searching for Hardships and Obstacles to Shots (SHOTS) survey. 1 Orbea et al examined attitudes, behaviors, and beliefs about COVID-19 vaccines in caregivers of hospitalized children and general vaccine hesitancy using the Parent Attitudes about Childhood Vaccines (PACV) Survey over 3 seasons during the COVID-19 pandemic.2 Both studies identified a notable gap in immunization coverage for hospitalized children.In Lissinna et al, only 58.2% of hospitalized patients were up-to-date on all immunizations, well below population-based provincial vaccine coverage rates; in Orbea et al, only 17% of hospitalized children had received the COVID-19 vaccine, consistent with low national coverage of COVID-19 vaccines in children.1,2 Improving vaccine delivery during hospitalization has the potential for significant public health impact by increasing childhood vaccine coverage if the barriers to inpatient vaccine delivery can be identified and overcome.The hospital setting is a missed opportunity to provide vaccines to children.In prior studies, 27% to 84% of pediatric inpatients were missing $ 1 recommended childhood vaccine, 3 and these numbers may be even larger now as pediatric vaccination rates have declined in the aftermath of the health care systems disruptions caused by the COVID-19 pandemic.4 Lissina et al identified that pediatric inpatients were less likely to be up-to-date than their same age cohorts in the surrounding province, suggesting immunization efforts may be even more critical for the hospitalized population. 1 Although a majority of caregivers are supportive of inpatient vaccination, 5 vaccines are delivered in <2% of hospitalizations at children's hospitals nationally.6 This mismatch is in line with a key finding in Orbea et almost caregivers who intended to vaccinate their child with the COVID-19 vaccine were willing to vaccinate during hospitalization, yet few were offered vaccines during hospitalization.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.093 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.007 | 0.004 |
| Scholarly communication | 0.009 | 0.021 |
| Open science | 0.004 | 0.010 |
| Research integrity | 0.012 | 0.021 |
| Insufficient payload (model declined to judge) | 0.023 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".