Kevin J. Dombkowski, General Pediatrics, Child Health Evaluation and Research Unit, University of Michigan, 300 North Ingalls, Room 6C11, Ann Arbor, MI, USA, Paula M. Lantz, School of Public Health, University of Michigan, and Gary L. Freed, Child Health Evaluation and Research Unit, University of Michigan, 300 North Ingalls Room 627, Ann Arbor, MI, USA.
KEYWORDS:
child, preschool; vaccination; immunization schedule; risk factors; logistic models.
BACKGROUND:
Risk factors for inadequate vaccination based on up-to-date status consider the likelihood of a given dose being received, while those based on delays in age-appropriate vaccination take into consideration the likelihood of receiving doses by the recommended ages.
OBJECTIVE:
To estimate the risk factors of children experiencing delay in age-appropriate vaccination and contrast those results with the risks of not being up-to-date, using a nationally-representative population of children.
METHOD:
Retrospective analysis of the risk factors of vaccination delay for children aged 25 months through 6 years from the National Health Interview Survey (NHIS) Immunization Supplement. Adjusted odds ratios were estimated using multivariate logistic regression for models of up-to-date vaccination status and for vaccination delay
for the DTP4, Polio3, MMR1 doses and 4:3:1 series using age-appropriate vaccination standards.
RESULT:
Absence of a two-parent household, large family size, parental education level of high school or less, Medicaid enrollment, absence of a usual provider, no insurance coverage, and households without a telephone were significantly related to an increased likelihood of a child experiencing delay for one or more of the DTP4, polio3, and MMR1 doses and the 4:3:1 vaccination series (p °Ü .05). Risk models based upon up-to-date status did not reveal many of the risk factors that were observed in the models of vaccination delay.
CONCLUSION:
Risk models based solely upon up-to-date vaccination status offer a limited perspective on the factors associated with inadequate vaccination status. Populations at increased risk of inadequate vaccination can be more clearly identified through risk models based upon age-appropriate vaccination status.
LEARNING OBJECTIVES:
To illustrate how rates of risk models based upon age-appropriate vaccination status can substantially vary from those based upon up-to-date status.
See more of Why Children in Underserved Areas are Receiving Vaccinations Late: Programs Implemented to Increase Coverage Rates in Pocket of Need Areas
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