Missed opportunities for vaccination and the delivery of preventive care

Thomas M. Ball, Janet Rose Serwint

Research output: Contribution to journalArticle


Objectives: To evaluate the relative impact of 2 types of missed opportunities (MOs) for vaccination, acknowledged and unacknowledged, on the immunization status of children at 2 years of age and to measure the delivery of immunizations and health care maintenance (HCM) after these types of MOs. Design: Case-control study. Setting: A large multispecialty clinic serving primarily a managed care population in Tucson, Ariz. Patients: Charts of 1165 patients, ages 2 to 4 years, were reviewed for immunization status by 2 years of age. Of these patients, 652 had received all of their medical care at the clinic during their first 2 years of life. The 76 patients found to be underimmunized (UI) at 2 years of age and 76 controls, who were fully immunized (FI) by 2 years of age, frequency matched for age, were studied. Main Outcome Measures: The charts were reviewed for the following information: sex, age, immunizations received, HCM visits, sick visits, MOs, and pediatrician-patient interchange regarding immunization status during visits. Results: Of the children who received all their care at the study site, 88% were FI. The mean number of MOs per patient occurring during the first 2 years of life was 5.8 for the UI children and 2.6 for the FI children. Only an unacknowledged MO, defined as a visit when the patient's immunization status was not reviewed, was associated with having a deficient immunization status at 2 years of age (4.6 vs 1.7, P

Original languageEnglish (US)
Pages (from-to)858-861
Number of pages4
JournalArchives of Pediatrics and Adolescent Medicine
Issue number8
Publication statusPublished - Aug 1996


ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this