Learning Objectives for this Presentation:
By the end of this presentation participants will be able to describe the survey methodology that was developed to assess vaccination coverage levels among Texas child care attendees.

Background:
In Texas, children attending child care facilities (including registered family homes) are required to have age appropriate vaccination against diphtheria, tetanus, pertussis, Haemophilus influenzae type b, polio, measles, mumps, rubella, varicella, pneumococcal disease, hepatitis B, and hepatitis A.

Objectives:
To develop and conduct a survey to assess vaccination coverage levels among Texas child care attendees.


Methods:
A new survey methodology was developed in 2005 to assess vaccination coverage levels among child care attendees aged 19 to 59 months. The sampling design consisted of a stratified cluster sample, with 100 child care facilities (including registered family homes) randomly selected based on probability proportional to size sampling from the 8 health service regions (HSRs) in Texas. Since only capacity and not enrollment data were known and wide variability existed in capacity size, it was decided to randomly select only 20 child immunization records per facility, or total enumeration if there were less than 20 children aged 19 to 59 months at the facility. Vaccination coverage level estimates were calculated for each HSR and statewide.

Results:
Statewide coverage level estimates ranged from 95% for 3 doses of polio vaccine to nearly 25% for 2 doses of hepatitis A vaccine. Among the HSRs, coverage level estimates ranged from a high of 97% for 3 doses of polio vaccine in HSR 2/3 (Dallas-Ft. Worth/North Central Texas) to nearly 11% for 2 doses of hepatitis A vaccine in HSR 4/5N (East Texas) and HSR 7 (Austin/Central Texas).

Conclusions:
Vaccination coverage level estimates varied among the HSRs and were lower than coverage levels calculated from child care audit data.