BACKGROUND:
In January 2002, the Pennsylvania Department of Health (PA-DOH) finalized the Immunization Requirements for Children in Child Care Group Settings regulation. This regulation affects approximately 5,000 licensed child care facilities and 450,000 infants and children attend these facilities.

OBJECTIVE:
1) To increase immunization coverage rates among infants and children from 2 months through five years of age.
2) To decrease the incidence of vaccine preventable diseases among preschooler population.
3) To assess, develop, and implement stratigic interventions as indicated.

METHOD:
1) Child care providers must obtain a written immunization record for each child under their care. Each child's immunization status must be summarized and reported to the DOH on an annual basis, on a form provided by the DOH, and by the date prescribed by the DOH.
2) To verify child care provider self-reporting, three to five percent of child care facilities will be randomly selected each year; immunization records of children under their care will be audited.

RESULT:
In January 2003, a pilot project was conducted by the DOH, which involved approx. 600 child care facilities and 25,000 infants and children. The self-reporting coverage rates coincided with the NIP annual survey as well as the state annual WINCASA report. In January 2004, the regulation will be implemented statewide.

CONCLUSION:
Child care regulation is the best way to assess and promote immunizations in the infant and preschooler population.

LEARNING OBJECTIVES:
How to effectively collect and verify immunization status of infant and preschool children.