Canadian Journal of Public Health

, Volume 91, Issue 6, pp 426–430 | Cite as

Health Diaries for Monitoring Events Following Immunization

  • Thomas R. FreemanEmail author
  • Moira Stewart
  • Richard Birtwhistle
  • Denise Cloutier Fisher


The present study set out to determine the validity of the information and the feasibility of using health diaries to monitor vaccine adverse events.

Mothers of children about to receive DPT vaccine were asked to keep a diary of their child’s health and their doctors were randomized into one of three groups: 1) a close follow-up (CFG); 2) a telephone follow-up (TFG); or 3) a mail follow-up group (MFG).

Diary return rates were good at 98.8%, 82.5%, and 86.2% for the CFG, TFG, and MFG groups respectively. Agreement between the parent and nurse on the existence of common symptoms was high, varying from 89.9% to 98.7%; redness and swelling was high at 78.5% and 96.2% respectively; and axillary temperatures was lower from 71.6% up.

This study found that health diaries were a valid and complete method for monitoring the most common types of vaccine-related illness, with the possible exception of body temperature.


L’étude visait à déterminer la validité de l’information des carnets de santé et la valeur pratique de leur utilisation pour suivre les effets indésirables des vaccins.

Nous avons demandé aux mères d’enfants prêts à recevoir le vaccin DCT de tenir un carnet de santé pour leurs enfants. Les mères et leurs médecins ont été regroupés de façon aléatoire en trois groupes: 1) un groupe suivi en personne (GSP), 2) un groupe suivi par téléphone (GST) et 3) un groupe suivi par correspondance (GSC).

Le taux de retour des carnets a été bon: 98,8 %, 82,5 % et 86,2 % respectivement pour le GSP, le GST et le GSC. Mères et infirmières se sont entendues dans une proportion élevée quant à la présence des symptômes communs (de 89,9 % à 98,7 %), de rougeurs (78,5 %) et d’enflures (96,2 %), mais dans une moindre proportion (71,6 % et plus) en ce qui avait trait à la température axillaire.

L’étude démontre que les carnets de santé sont une méthode valide et complète pour suivre les types les plus communs de réactions aux vaccins, à l’exception, peut-être, de la température corporelle.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    The Consensus Workshop to Explore a Framework for Determining Risk of Unexpected Events Following Medical Intervention. Ottawa, Ontario. Sponsored by the Drugs Directorate of Health and Welfare Canada and The College of Family Physicians of Canada, 1989.Google Scholar
  2. 2.
    Meekison W, Hutchison M, Guasparini R, et al. Post-marketing surveillance of adverse events following Prohibit vaccine–British Columbia. Can Dis Wkly Rep 1989;July 15:143–45.PubMedGoogle Scholar
  3. 3.
    Laverne B, Frappier-Davignon L. Can Dis Wkly Rep May 1986.Google Scholar
  4. 4.
    Freeman TR, Stewart MA, Turner L. Illness after Measles-Mumps-Rubella vaccination. Can Med Assoc J 1993;149:1669–74.Google Scholar
  5. 5.
    Freer, CB. Self care: A health diary study. Med Care 1980;XVIII(8):853–61.CrossRefGoogle Scholar
  6. 6.
    Dahlquist G, Wall S, Ivarsson JI, et al. Health problems and care in young families–An evaluation of survey procedure. Int J Epidemiol 1984;2(13):221–28.CrossRefGoogle Scholar
  7. 7.
    West SR, Harris, BJ. The effect of personal characteristics on response levels in a health survey. NZ Med J 1983;Aug 24:666–68.Google Scholar
  8. 8.
    Duffy, ME. Primary prevention behaviors: The female headed one-parent family. Res Nurs Health 1986;9:115–22.CrossRefGoogle Scholar
  9. 9.
    Cunningham-Burley S, Irvine S. “And have you done anything so far?” An examination of lay treatment of children’s symptoms. Br Med J 1987;295:700–702.CrossRefGoogle Scholar
  10. 10.
    Follick MJ, Ahern DK, Laser-Wolston N. Evaluation of a daily activity diary for chronic pain patients. Pain 1984;19:373–82.CrossRefGoogle Scholar
  11. 11.
    Murray J. The use of health diaries in the field of psychiatric illness in general practice. Psychol Med 1985;15:827–40.CrossRefGoogle Scholar
  12. 12.
    Richardson GM, McGrath PJ, Cunningham SJ, Humphreys P. Validity of the headache diary for children. Headache 1983;July:184–87.Google Scholar
  13. 13.
    Heitkamper MM, Shaver JF, Mitchell, ES. Gastrointestinal symptoms and bowel patterns across the menstrual cycle in dysmenorrhea. Nurs Res 1988;37(2):108–13.Google Scholar
  14. 14.
    Sveindsottir H, Reame N. Symptom patterns in women with premenstrual syndrome complaints: A prospective assessment using a marker for ovulation and screening criteria for adequate ovarian functioning. J Adv Nurs 1991;16(6):689–700.CrossRefGoogle Scholar
  15. 15.
    Bentzen N, Christiansen T, Pedersen, KM. Self care within a model for demand for medical care. Soc Sci Med 1989;29(2):185–93.CrossRefGoogle Scholar
  16. 16.
    Tonai S, Maezawa M, Kamei M, et al. Illness behavior of housewives in a rural area in Japan: A health diary study. Cult Med Psychiatry 1989;13:405–17.CrossRefGoogle Scholar
  17. 17.
    Rakowski L, Julius M, Hickey T, et al. Daily symptoms and behavioral responses: Results of a health diary with older adults. Med Care 1988;26(3):278–97.CrossRefGoogle Scholar
  18. 18.
    Shalit N, Fattal B. The health diary as a source of information on kibbutz morbidity. Is J Med Sci 1990;26(2):80–87.Google Scholar
  19. 19.
    Norman G, McFarlane AH, Streiner D, Neale K. Health diaries: Strategies for compliance and relation to other measures. Med Care 1982;20(6):623–29.CrossRefGoogle Scholar
  20. 20.
    Roghmann KJ, Haggerty, RJ. the diary as a research instrument in the study of health and illness behavior. Med Care 1972;2(X):143–63.CrossRefGoogle Scholar
  21. 21.
    Carp FM, Carp A. The validity, reliability, and generalizability of diary data. Exp Aging Res 1981;3:281–96.CrossRefGoogle Scholar
  22. 22.
    Hull SB, Cummings SR (Eds.). Designing Clinical Research. Baltimore: Williams & Wilkins, 1988.Google Scholar
  23. 23.
    Moser CA, Kalton G. Survey Methods in Social Investigation 2nd edition. London: Heinemann Education Books Limited, 1971.Google Scholar

Copyright information

© The Canadian Public Health Association 2000

Authors and Affiliations

  • Thomas R. Freeman
    • 1
    Email author
  • Moira Stewart
    • 2
  • Richard Birtwhistle
    • 3
  • Denise Cloutier Fisher
    • 4
  1. 1.Department of Family MedicineThe University of Western OntarioCanada
  2. 2.Centre for Studies in Family MedicineThe University of Western OntarioCanada
  3. 3.Department of Family MedicineQueen’s UniversityCanada
  4. 4.College of Family Physicians of CanadaCanada

Personalised recommendations