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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3154.0: Monday, December 12, 2005 - Board 6

Abstract #115425

Potential for 90% vaccination coverage of young children

Tom T. Shimabukuro, MD, MPH, MBA1, Elizabeth T. Luman, PhD, MS2, Richard A. Schieber, MD, MPH1, and Carla A. Winston, PhD, MA1. (1) Health Services Research and Evaluation Branch, Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-52, Atlanta, GA 30333, 404-639-8542, TShimabukuro@cdc.gov, (2) Assessment Branch, Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E62, Atlanta, GA 30333

Background: Up-to-date (UTD) coverage for the universally recommended vaccination series in young children falls well short of the target 90%, and racial/ethnic and regional disparities persist. We determined the projected change in UTD coverage achievable in young children with a single provider visit focused on administering catch-up vaccinations.

Methods: Using a simulated retrospective cohort of 24-month old children derived from the 2003 National Immunization Survey, we calculated the projected change in UTD coverage if non-UTD children were to receive a single provider visit focused on obtaining up to four missing vaccinations. We also performed a stratified analysis by race/ethnicity, state of residence, and census region.

Results: National coverage could increase from 35% observed UTD coverage at baseline to 92% projected UTD coverage after one such provider visit (P<0.001). Eighty-eight percent of non-UTD children would require only one simulated visit, of which 68% would require only one vaccination dose. Projected UTD coverage could increase substantially from baseline for racial/ethnic groups, from 38% to 94% for non-Hispanic whites, from 29% to 90% for non-Hispanic blacks, and from 31% to 91% for Hispanics (P<0.001 for each pre-post comparison). All states could exceed 87% projected UTD coverage, and 40 states and all census regions could achieve >90% projected UTD coverage.

Conclusion: Using the well-child visit typically scheduled around the second birthday as a focused opportunity to administer missing vaccinations could theoretically increase national UTD coverage to >90%. Racial/ethnic disparities would become functionally minimal and UTD coverage would greatly increase in all states and regions.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

Keywords: Immunizations, Children's Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Public Health Strategies for Child Health Promotion

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA