Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe estimated immunization coverage levels and demographic information on daycare centers in Idaho.

Background:
Each year, Idaho evaluates immunization coverage of children enrolled in daycare by conducting a state-wide random sample of 15% of licensed child care facilities. Idaho and CDC performed an evaluation study in 2003-2004.

Objectives:
The objective of this analysis was to assess the up-to-date (UTD) status of a random sample of children in Idaho daycare centers, and identify factors associated with UTD status.

Methods:
In each of Idaho's seven health districts, we selected a random sample of licensed daycare facilities. Selection of the facilities was stratified based on size (family daycare 1-6, group daycare 7-12, and centers >12). Regional health department staff visited each of the facilities in their regions and reviewed the records of all children. UTD status was assessed for single antigens; DTaP, Polio, MMR, Hib, and Hepatitis B and the combined series (4:3:1:3:3) for the children at multiple age milestones: 3, 5, 7, 12 and 24 months. The sample included 6,321 children in 393 schools.

Results:
The coverage for individual antigens at 24 months was: DTaP4 (45%), Polio3 (76%), MMR1 (71%), Hib3 (72%), and HepB3 (72%). Nearly two-thirds (64%) of the subjects were enrolled in daycare full-time. We found that children enrolled less than full-time were significantly more likely to be UTD for 4:3:1:3:3 at age 24 months than those who attended childcare full-time (p=0.01). UTD status at 24 months varied significantly by region (p<0.0001).

Conclusions:
Estimated vaccine coverage by 2 years of age in Idaho children enrolled in daycare in 2004 was lower than expected. The extent to which this reflects incomplete immunization records at daycare centers or actual under-immunization is unknown. Further efforts are needed to improve record keeping and vaccination levels.