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Potential for improving age-appropriate vaccination coverage by maximizing the 18-month well-child visit.

AbstractOBJECTIVE: To evaluate potential age-appropriate up-to-date (UTD) vaccination coverage achievable in preschool children if missing vaccinations were administered during a well-child visit at 18 months of age. METHODS: Data from the 2004 National Immunization Survey were used in a series of simulations analyzing UTD coverage of the 4:3:1:3:3:1 (diphtheria, tetanus, pertussis/poliovirus/measles-containing vaccine/Haemophilus influenzae type b/hepatitis B/varicella) and 4:3:1:3:3:1 (+) pneumococcal conjugate vaccine (PCV) series. In the models, children not already up-to-date received up to four missing vaccinations during a simulated routine 18-month-old well-child visit. RESULTS: For the 4:3:1:3:3:1 series, UTD coverage increased from baseline 61 percent (95% confidence interval [CI] = 60-62) to simulated 87 percent (95% CI = 86-88). Among the baseline non-UTD children, 69 percent became up-to-date by simulation with the single visit, of which 44 percent required only one vaccination. For the 4:3:1:3:3:1 (+) PCV series, UTD coverage increased from baseline 38 percent (95% CI = 37-40) to simulated 74 percent (95% CI = 73-75). Among the baseline non-UTD children, 59 percent became up-to-date by simulation with the single visit, of which 47 percent required only one vaccination. UTD coverage increased substantially for all racial/ethnic groups and in all states. CONCLUSIONS: Taking full advantage of the recommended 18-month-old well-child visit to administer missing vaccines would be a strategically timed opportunity to achieve high age-appropriate UTD coverage in preschool children.
AuthorsTom T Shimabukuro, Elizabeth T Luman, Carla A Winston, Richard A Schieber (Affiliation: Health Services Research and Evaluation Branch, Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia 30333, USA. TShimabukuro at cdc.gov)
JournalJournal of public health management and practice : JPHMP (J Public Health Manag Pract) 2007 Nov-Dec Vol. 13 Issue 6 Pg. 572-7 ISSN: 1078-4659 United States
PMID17984710 (Publication Type: Journal Article)
Chemical References
  • Vaccines
Topics
  • Age Factors
  • Child Health Services (organization & administration, statistics & numerical data)
  • Continental Population Groups
  • Ethnic Groups
  • Humans
  • Immunization Schedule
  • Infant
  • Time Factors
  • Vaccination
  • Vaccines (administration & dosage)