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Factors associated with underimmunization at 3 months of age in four medically underserved areas.
Public Health Rep. 2004 Sep-Oct; 119(5):479-85.PH

Abstract

OBJECTIVE

Risk factors for underimmunization at 3 months of age are not well described. This study examines coverage rates and factors associated with under-immunization at 3 months of age in four medically underserved areas.

METHODS

During 1997-1998, cross-sectional household surveys using a two-stage cluster sample design were conducted in four federally designated Health Professional Shortage Areas. Respondents were parents or caregivers of children ages 12-35 months: 847 from northern Manhattan, 843 from Detroit, 771 from San Diego, and 1,091 from rural Colorado. A child was considered up-to-date (UTD) with vaccinations at 3 months of age if documentation of receipt of diphtheria-tetanus-pertussis, polio, haemophilus influenzae type B, and hepatitis B vaccines was obtained from a provider or a hand-held vaccination card, or both.

RESULTS

Household response rates ranged from 79% to 88% across sites. Vaccination coverage levels at 3 months of age varied across sites: 82.4% in northern Manhattan, 70.5% in Detroit, 82.3% in San Diego, and 75.8% in rural Colorado. Among children who were not UTD, the majority (65.7% to 71.5% per site) had missed vaccines due to missed opportunities. Factors associated with not being UTD varied by site and included having public or no insurance, >/=2 children living in the household, and the adult respondent being unmarried. At all sites, vaccination coverage among WIC enrollees was higher than coverage among children eligible for but not enrolled in WIC, but the association between UTD status and WIC enrollment was statistically significant for only one site and marginally significant for two other sites.

CONCLUSIONS

Missed opportunities were a significant barrier to vaccinations, even at this early age. Practice-based strategies to reduce missed opportunities and prenatal WIC enrollment should be focused especially toward those at highest risk of underimmunization.

Authors+Show Affiliations

Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-52, Atlanta, GA 30333, USA. bfb7@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15313111

Citation

Bardenheier, Barbara H., et al. "Factors Associated With Underimmunization at 3 Months of Age in Four Medically Underserved Areas." Public Health Reports (Washington, D.C. : 1974), vol. 119, no. 5, 2004, pp. 479-85.
Bardenheier BH, Yusuf HR, Rosenthal J, et al. Factors associated with underimmunization at 3 months of age in four medically underserved areas. Public Health Rep. 2004;119(5):479-85.
Bardenheier, B. H., Yusuf, H. R., Rosenthal, J., Santoli, J. M., Shefer, A. M., Rickert, D. L., & Chu, S. Y. (2004). Factors associated with underimmunization at 3 months of age in four medically underserved areas. Public Health Reports (Washington, D.C. : 1974), 119(5), 479-85.
Bardenheier BH, et al. Factors Associated With Underimmunization at 3 Months of Age in Four Medically Underserved Areas. Public Health Rep. 2004;119(5):479-85. PubMed PMID: 15313111.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with underimmunization at 3 months of age in four medically underserved areas. AU - Bardenheier,Barbara H, AU - Yusuf,Hussain R, AU - Rosenthal,Jorge, AU - Santoli,Jeanne M, AU - Shefer,Abigail M, AU - Rickert,Donna L, AU - Chu,Susan Y, PY - 2004/8/18/pubmed PY - 2004/9/24/medline PY - 2004/8/18/entrez SP - 479 EP - 85 JF - Public health reports (Washington, D.C. : 1974) JO - Public Health Rep VL - 119 IS - 5 N2 - OBJECTIVE: Risk factors for underimmunization at 3 months of age are not well described. This study examines coverage rates and factors associated with under-immunization at 3 months of age in four medically underserved areas. METHODS: During 1997-1998, cross-sectional household surveys using a two-stage cluster sample design were conducted in four federally designated Health Professional Shortage Areas. Respondents were parents or caregivers of children ages 12-35 months: 847 from northern Manhattan, 843 from Detroit, 771 from San Diego, and 1,091 from rural Colorado. A child was considered up-to-date (UTD) with vaccinations at 3 months of age if documentation of receipt of diphtheria-tetanus-pertussis, polio, haemophilus influenzae type B, and hepatitis B vaccines was obtained from a provider or a hand-held vaccination card, or both. RESULTS: Household response rates ranged from 79% to 88% across sites. Vaccination coverage levels at 3 months of age varied across sites: 82.4% in northern Manhattan, 70.5% in Detroit, 82.3% in San Diego, and 75.8% in rural Colorado. Among children who were not UTD, the majority (65.7% to 71.5% per site) had missed vaccines due to missed opportunities. Factors associated with not being UTD varied by site and included having public or no insurance, >/=2 children living in the household, and the adult respondent being unmarried. At all sites, vaccination coverage among WIC enrollees was higher than coverage among children eligible for but not enrolled in WIC, but the association between UTD status and WIC enrollment was statistically significant for only one site and marginally significant for two other sites. CONCLUSIONS: Missed opportunities were a significant barrier to vaccinations, even at this early age. Practice-based strategies to reduce missed opportunities and prenatal WIC enrollment should be focused especially toward those at highest risk of underimmunization. SN - 0033-3549 UR - https://www.unboundmedicine.com/medline/citation/15313111/Factors_associated_with_underimmunization_at_3_months_of_age_in_four_medically_underserved_areas_ L2 - http://journals.sagepub.com/doi/full/10.1016/j.phr.2004.07.005?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -