Study Design: Models of the risks of vaccination delay were estimated based upon cross-sectional data from the 1992 - 1996 National Health Interview Survey (NHIS). Simulation exercises were conducted to estimate the expected risk of delays of 1 - 6 months, greater than 7 months, or not receiving the vaccination, and to assess the potential benefits of removing existing barriers to age-appropriate vaccination.
Principal Findings: Although 81% of high-risk children between 25 and 72 months were expected to be up-to-date for the DTP4 dose, only 28% were expected to receive this dose without any delay prior to vaccination. For the polio3 dose, 85% were expected to be up-to-date, and only 54% with no delay. 86% of children were expected to receive the MMR1 dose, but only 50% with no delay. Removal of medical home and insurance barriers raised the expectation of no delay to 44% for the DTP4 dose, to 64% for the polio3 dose, and to 67% for the MMR1 dose. Families with more that one child, and those from homes without telephone were found to have the greatest potential for reduction in vaccination delays.
Implications for Policy, Delivery, or Practice: The removal of key access barriers, such as not having health insurance or a usual source of medical care can substantially reduce vaccination delay. In addition, provider and parent education programs that focus on families with more that one child, and those from homes without a telephone have the greatest potential for reduction in vaccination delay.
Learning Objectives: Participants in this session will be able to identify the leading risk factors for delays in childhood immunization. In addition, simulation analysis results will help participants recognize the potential impacts of the removal of barriers to age-appropriate vaccination, and will assist in the assessment of alternative interventions aimed at reducing vaccination delay.
Keywords: Immunizations, Risk Factors
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: This study was supported in part by a grant to Dr. Dombkowski from the Blue Cross Blue Shield Foundation of Michigan