On-Time Immunization Rates Among Children Who Enter Chicago Public Schools

Author:

Dominguez Samuel R.1,Parrott J. Scott2,Lauderdale Diane S.3,Daum Robert S.1

Affiliation:

1. Pediatric Immunization Program and the Department of Pediatrics, University of Chicago, Chicago, Illinois

2. Independent consultant, Chicago, Illinois

3. Department of Health Studies, University of Chicago, Chicago, Illinois

Abstract

Objective. A primary objective of the Healthy People 2010 initiatives is to increase on-time immunization rates during the first 2 years of life and to decrease racial disparities in coverage. The objective of this study was to determine on-time immunization coverage rates among infants and toddlers stratified by race/ethnicity in a large metropolitan center. Methods. A retrospective cohort study that was based on immunization records in the Chicago Public Schools computerized database was conducted using all 67376 children who completed kindergarten in 2001 and 2002. Results. On-time immunization rates in Chicago public school children are low (31% at 7 months, 32% at 19 months, 59% at 36 months). At 19 months of age and thereafter, Hispanic children had the highest rate of on-time immunization coverage. Among children <48 months old, black children had the lowest rates of up-to-date immunization status. At 48 months of age, the up-to-date rate for black children improved to a rate similar to white children (58%) and by school entry surpassed the up-to-date rate for white children (71%). Compared with the recommended 2, 4, 6, and 15 to 18 months schedule, black children received 4 doses of diphtheria/tetanus/acellular pertussis at a mean age of 10.0, 14.6, 20.4, and 34.5 months of age. In contrast, Hispanic children received the same doses at a mean of 4.5, 7.4, 11.0, and 25.1 month of age. In addition, ∼25% of black children received the majority of their vaccinations >12 months later than the recommended time intervals. Conclusions. Striking immunization delay still exists during the infant and toddler years. Targeted efforts are needed to increase on-time immunization rates and to decrease racial disparity in immunization coverage.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference41 articles.

1. US Department of Health and Human Services. Healthy People 2010: National Health Promotion and Disease Prevention Objectives. Washington DC: US Public Health Service; 2000

2. Centers for Disease Control and Prevention. Vaccination coverage by race/ethnicity and poverty level among children ages 19–35 months—United States 1997. MMWR Morb Mortal Wkly Rep. 1998;47:956–959

3. Centers for Disease Control and Prevention. National, state, and urban area vaccination levels among children aged 19–35 months—United States, 2002. MMWR Morb Mortal Wkly Rep. 2003;52:728–732

4. Luman ET, Barker LE, Simpson DM, Rodewald LE, Szilagyi PG, Zhao A. National, state, and urban-area vaccination-coverage levels among children aged 19–35 months, United States, 1999. Am J Prev Med. 2001;20:88–154

5. Centers for Disease Control and Prevention. Recommended childhood immunization schedule—United States, January-June 1996. MMWR Morb Mortal Wkly Rep. 1996;44:940–943

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