Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Dr. Christina Quick

Second Advisor

Dr. Sandra Spoelstra

Third Advisor

Dr. Kim Fenbert

Academic Year



Objectives: In a small, rural pediatric primary care clinic, the effectiveness of electronic patient portal reminders were evaluated at improving vaccination rates for school required immunizations.

Methods: A quality improvement project was initiated utilizing The Social Ecological Model. All pediatric patients were sent reminders who were under-immunized. This QI project evaluated the effectiveness of vaccine reminders on the improvement of immunization rates in the clinic

Results: Total number of fully-vaccinated patients within the practice improved (2%) and patients under-immunized decreased by 1%. 87 immunizations were given to patients were given to patients who were under-immunized and an average of 10% of recorded un-vaccinated patient prior to intervention received at least one immunization.

Conclusions: Implementation of vaccine reminders into a rural primary care pediatric practice improved patient compliance with school-required vaccines. Although immunization rates improved, the practice continues to see higher rates of under-immunized patients compared to state reporting data.

Key Words: Vaccines, improvement, pediatric, primary care, portal reminder, vaccination rates