Immunization coverage and its relationship to preventive health care visits among inner-city children in Baltimore.

Abstract

OBJECTIVE:

To provide empirical data on immunization coverage and the receipt of preventive health care to inform policy makers' efforts to improve childhood immunization.

DESIGN AND METHODS:

We surveyed a random sample drawn from a birth cohort of 557 2-year-old children living in the inner-city of Baltimore. Complete information on all their preventive health care visits and immunization status was obtained from medical record audits of their health care providers.

MAIN OUTCOME MEASURES:

Age-appropriate immunizations and preventive health care visits.

RESULTS:

By 3 months of age, nearly 80% made an age-appropriate preventive health visit, but by 7 months of age, less than 40% had a preventive visit that was age-appropriate. In the second year of life, 75% made a preventive health visit between their 12- and 17-month birthdays. The corresponding age-appropriate immunization levels were 71% for DTP1, 39% for DTP3, and 53% for measles-mumps-rubella vaccine. Infants who received their DTP1 on-time were twice as likely to be up-to-date by 24 months of age.

CONCLUSIONS:

Our analyses focus attention on the performance of the primary health care system, especially during the first 6 months of life. Many young infants are underimmunized despite having age-appropriate preventive visits, health insurance coverage through Medicaid, and providers who receive free vaccine from public agencies. Measles vaccination coverage could be improved by initiating measles-mumps-rubella vaccine vaccination, routinely, at 12 months among high risk populations.

• Authors: B Guyer, N Hughart, E Holt, A Ross, B Stanton, V Keane, N Bonner, D M Dwyer, J S Cwi
• Journal: Pediatrics (Pediatrics) Vol. 94 Issue 1 Pg. 53-8 (Jul 1994) ISSN: 0031-4005 [Print] United States
• PMID: 8008538 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Diphtheria-Tetanus-Pertussis Vaccine
• Drug Combinations
• Measles Vaccine
• Measles-Mumps-Rubella Vaccine
• Mumps Vaccine
• Poliovirus Vaccine, Inactivated
• Rubella Vaccine

Topics

• Baltimore
• Child, Preschool
• Cohort Studies
• Diphtheria-Tetanus-Pertussis Vaccine (therapeutic use)
• Drug Combinations
• Humans
• Immunization Schedule
• Measles Vaccine (therapeutic use)
• Measles-Mumps-Rubella Vaccine
• Mumps Vaccine (therapeutic use)
• Poliovirus Vaccine, Inactivated (therapeutic use)
• Poverty Areas
• Preventive Health Services (statistics & numerical data)
• Rubella Vaccine (therapeutic use)
• Selection Bias
• Urban Health
• Vaccination (statistics & numerical data)