KEYWORD1:
Immunization assessment, pockets of need, retrospective survey, missed opportunities

BACKGROUND:
In 2001, the Minnesota Department of Health (MDH) conducted a comprehensive retrospective survey of kindergartners. All 65,653 children enrolled in a kindergarten program during the 2000-01 school year were included in this survey. This is the third such survey conducted in Minnesota.

OBJECTIVE:
To demonstrate that geographic pockets of need exist within in all rural and urban areas statewide, to characterize these ?pockets,? and to show that they persisted over time.

METHOD:
School data were either submitted on paper abstraction forms, in a CASA file format, or electronically from existing school computer systems or regional registries. Each student?s initials, date of birth, zip code of residence, immunization exemption status, race/ethnicity, and immunization history were collected.

RESULT:
When compared to 1997 data, the statewide rate for 4:3:1 for two-year-old children increased by 17 percentage points to 81.1%. However, immunization levels varied significantly by county/city area as well as within counties and cities by zip code. By eliminating missed opportunities for simultaneous administration, the percent up-to-date at 20 months for the 4:3:1 series would have improved from 74.8% to 83.0%. A total of 837 children (1.3%) were exempt from the school law due to conscientiously held beliefs. Vaccination rates differed by race/ethnicity of the child. Only 64.8% of children of color were up-to-date at two years of age compared to 85.5% of white children. Map overlays from GIS analysis of survey results and 2000 Census data will be presented.

CONCLUSION:
While vaccination levels within well-defined pockets of need have shown steady increase over time, disparities still remain.
LEARNINGOBJECTIVES:
The importance of population-based immunization assessment data will be demonstrated.