The organization, delivery and audit of a specialist immunization clinic.

Immunization is a key primary prevention activity which has assisted in the reduction of childhood morbidity and premature mortality. Uptake rates for two-year-old children are now in excess of 90 per cent throughout the UK and for the vast majority of infants immunization is a routine procedure with a high benefit-to-risk ratio. Concerns about particular children, either because of their previous medical history or an adverse vaccine event, have been responded to in various ways. The experiences of a specialist immunization facility established in 1987, which since inception has seen just over 3,000 children are described. The clinic operates four sessions a week, with two held in the District General Hospital and two in community clinics; the resource requirements for the clinic are identified. A parent satisfaction survey for the first 1,700 attenders was undertaken in 1992 and the results are reported; their comments led to changes in the method of service delivery. A study of GPs' views was also undertaken at the same time; their satisfaction with the service is reflected in the continuing level of referrals, It is believed that all provider units should consider developing a similar facility for five reasons. First, it provides a source of expert advice for both professionals and parents; second, it facilitates the immunization of children with problem histories; third, it enables the investigation of serious post-vaccination adverse events; and fourth, the clinic provides a means of co-ordinating and delivering neonatal immunizations (including BCG, HBV, Varicella zoster and the vaccination of pre-term infants). And finally the clinic offers training for health care staff involved in primary immunization programmes and travel vaccination services.