Deficiencies in current childhood immunization indicators

P. Bolton, A. Hussain, A. Hadpawat, E. Holt, N. Hughart, B. Guyer

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. To investigate 'up-to-date' and 'age-appropriate' indicators of preschool vaccination status and their implications for vaccination policy. Methods. The authors analyzed medical records data from the Baltimore Immunization Study for 525 2-year-olds born from August 1988 through March 1989 to mothers living in low-income Census tracts of the city of Baltimore. Results. While only 54% of 24-month-old children were up-to-date for the primary series, indicators of up-to-date coverage were consistently higher, by 37 or more percentage points, than corresponding age-appropriate indicators. Almost 80% of children who failed to receive the first dose of DTP or OPV age-appropriately failed to be up-to-date by 24 months of age for the primary series. Conclusions. Age-appropriate immunization indicators more accurately reflect adequacy of protection for preschoolers than up-to-date indicators at both the individual and population bevels. Age-appropriate receipt of the first dose of DTP should be monitored to identify children likely to be underimmunized. Age-appropriate indicators should also be incorporated as vaccination coverage estimators in population-based surveys and as quality of care indicators for managed care organizations. These changes would require accurate dates for each vaccination and support the need to develop population-based registries.

Original languageEnglish (US)
Pages (from-to)527-532
Number of pages6
JournalPublic health reports
Volume113
Issue number6
StatePublished - Dec 1 1998

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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