Date of Graduation


Document Type


Degree Type



School of Nursing


Adult Health

Committee Chair

Mary Jane Smith

Committee Co-Chair

Stacey Culp

Committee Member

Ronald E Greer

Committee Member

Teresa Ritchie


Background: Vaccines are one of the most successful and easily accessible prevention tools available to clinical practitioners in the United States. Falling levels of immunity in the entire population amplify concern for increases in preventable childhood diseases, making improving vaccination rates an important goal for current clinical practitioners (Omer et al., 2009).;Purpose: The purpose of this intervention was to increase the percentage of vaccinated children 0-6 years of age by sending a reminder letter to parent/guardians of children who are unvaccinated and under-vaccinated per the CDC's current immunization recommendations at a rural health center in West Virginia.;Project: The project plan was to (1) determine the percentage of children age 0-6 years in a rural family practice who are and are not fully immunized per the CDC's current immunization schedule; (2) develop an immunization reminder letter for caregivers of the children who are not fully immunized; (3) mail the immunization reminder letter to identified caregivers; (4) determine if the mailed reminder letter increased the number of children who are fully immunized per the CDC's current immunization schedule.;Summary of Findings: The project goal of increasing the number of children whose immunizations were up to date per the CDC's current immunization schedule was met. At the beginning of the intervention, 56% (n=130) of children age 0-6 at the rural health center were up to date per the CDC's current immunization recommendations. At the conclusion of the intervention 67% (n=156) of the eligible population were up to date, a 25% increase. This result was statistically significant (p=<0.001).;Implications: This project models a simple intervention rural family practices can implement to increase immunization rates among the pediatric population. In the future, the project can be used by other family practice settings to increase immunization rates.