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I have formulated my PICOT question around why it is important to vaccinate your children on a timely schedule from birth up to college age. This article has done surveys and followed families of certain childhood age groups. It also explains how face to face education by a provider is important . This along with reminders for well visits and vaccines by mail and internet based patient portals can be very effective in achieving compliance. 

Vaccination is one of the most important public health achievements of the 20th century . It is a cost-effective public health measure and has led to the global eradication of smallpox and large reductions in poliomyelitis, measles, tetanus, rubella, diphtheria, Haemophilus influenzae type b (Hib) and other conditions. However, over 22 million children are still not fully vaccinated , and there are significant variations in vaccination coverage within and between countries .Further, vaccination coverage rates in some countries are stagnating . Efforts to improve vaccination coverage in low- and middle-income countries (LMICs) are central to meeting the Millennium Development Goal (MDG) of reducing child mortality . ( Willis 2013)

Flow chart see below 

· Formulate clinical question 

· Using CINAHL search search by keywords and advanced search, checking off the boxes for examples such as location US,peer reviewed , and or date range

· Access and track down the best articles and evidence using peer reviewed articles on the library website or google search engine using keywords for your topic

· Evaluate articles for its evidence, validity and usefulness to your topic

· Apply and integrate the evidence to your clinical practice , patient care and conditions 

· Evaluate the new process for any tweaks or changes that need to be made ( CINAHL)

Reference