KEYWORDS:

BACKGROUND:
Children participating in WIC are less well-immunized than children who do not participate in WIC. Vaccination-promoting strategies in WIC produce dramatic improvements in coverage and other health outcomes.

OBJECTIVE(S):
To better target immunization activities in WIC by identifying risk factors for not being up-to-date (UTD) among WIC participants and to determine risk factors for dropping out of WIC.

METHOD(S):
Demographic data, WIC participation, and vaccination histories for children 19-35 months during April 1999 - April 2000 were collected from the National Immunization Survey. We defined children as UTD if they had received DPT4, 3rd polio, MMR1, and Hib3. Risk factors for underimmunization in WIC and for dropping out of WIC were assessed using multivariate logistic regression models. Children were considered eligible for WIC according to WIC criteria of reported family income <185% of federal poverty level.

RESULT(S):
Of 23,064 children, 11,301 (49%) participated in WIC sometime in their lives, and 5,887 (26%) were current WIC participants. Children who remained in WIC were better immunized than children who had dropped out (76% vs. 69%, p<.05). Black or Asian race, moving residence within the last year, younger age of child, and maternal education level < highschool were significantly associated with not being UTD among current WIC participants (p<.05). Among the children ever participating in WIC and meeting WIC-eligibility criteria, Hispanic race, income above 100% poverty level, suburban residence, older age of child, age of mother 20-29 years, and absence of a two-parent household were significantly associated with dropping out of WIC (p<.05).

CONCLUSIONS(S):
Dropping out of WIC is associated with significantly lower immunization levels. Almost 50% of WIC participants had dropped out sometime before their 3rd birthday. Identifying children likely to drop out of WIC and finding ways to keep them enrolled may translate into improved immunization and nutritional status.

LEARNING OBJECTIVES: