Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115425

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

(
• Articulate the potential impact on coverage of a single provider visit for incompletely vaccinated children occurring around the second birthday, focused on administering catch-up vaccinations. (
• Recognize the value of a such a visit in reducing racial/ethnic and regional disparities in vaccination coverage. (
• Articulate the value of the National Immunization Survey in monitoring and estimating vaccination coverage.

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.