BACKGROUND:
Public/private sector collaboration is required to attain the USPHS Healthy People 2010 Goal of 95% immunization completeness for all vaccines for children enrolled in child (day) care. Primary care reliance upon a “Pull Strategy” to increase immunization completeness (e.g. compliance with “Standards for Immunization Practices”) is not sufficient. Providing early educators with computer tools (e.g. WellCareTracker™) to track preventive care on enrolled children complements vaccine registry initiatives, and adds a “Push Strategy” to medical homes for vaccine update.

OBJECTIVE:
1. Annually measure immunization completeness of children attending child (day) care.
2. Pilot in child (day) care an internet-based software application to track preventive care, provide recall/reminders, and refer children to medical homes for overdue services.

METHOD:
Six years of statewide child care immunization data on a 10% sample of children (2002 = 13,645 children in 3,500 child care programs) was assessed. Field-testing of WellCareTracker™ (www.wellcaretracker.org), a web-application for educators to track health record data for 100% of enrolled children began in 2003. Changes in immunization documentation are measured.

RESULT:
Enrolled children in licensed centers are more completely immunized than similar age children in the general population. While some individual antigen completeness (2002-03) exceeds USPHS 2010 Goals, 4:3:1:3:3:1 completeness is only 74.5% for children ages 19-35 months. Trend data over six years show continual improvement, including varicella, and PCV-7. Child care programs are interested, willing, and able to use computer tools to track preventive care.

CONCLUSION:
Improving immunization performance for children attending child (day) care is achievable using a combination of public/private “Push-Pull” initiatives. As a tracking tool, Web-based WellCareTracker™, optimizes the use of limited resources.

LEARNING OBJECTIVES:
1. Present 6 years of immunization data of children in PA child (day) care centers.
2. Describe an internet-based software application enabling educators to track and refer children with immunization documentation deficiencies to their medical homes.