KEYWORDS:
vaccination status, record scattering, continuity of care

BACKGROUND:
The accurate, complete immunization record is central to appropriate assessment and immunization of each child and to valid coverage measurement at the clinic, health plan, and population levels. Record scattering resulting from children receiving immunizations from multiple providers has been identified as an important immunization delivery system barrier.

OBJECTIVE(S):
To assess record scattering related to children's immunization histories at the national and state-specific levels. To examine factors associated with the child's last provider having up-to-date records.

METHOD(S):
Analyses were conducted of the 2000 National Immunization Survey (NIS), a national survey providing provider-verified immunization estimates for preschool children 19-35 months of age. Immunization status of each child with multiple providers was compared using: 1) reconciled provider information, 2) the last provider's record, and 3) parent-held shots cards. At the national level logistic regression analyses were used to assess factors associated with whether or not the child's last provider had complete immunization information.

RESULT(S):
The percent of children whose latest provider do not have complete information will be estimated nationally and for each state. Preliminary record scatter data will be presented. Factors associated with record scattering will be presented.

CONCLUSIONS(S):
The accuracy and completeness of immunization records at the household/child, provider, and population levels may contribute to the timely and appropriate immunization of individual children and optimizing protection of preschool children. Reduction of record scattering could positively impact the protection of children and populations from vaccine-preventable diseases.

LEARNING OBJECTIVES:
Describe the extent and factors associated with immunization record scattering.