Learning Objectives for this Presentation:
By the end of the presentation, participants will have learned about barriers to on-time completion of four doses of DTaP vaccine

Background:
The Healthy People 2010 goal of 90% coverage with four doses DTaP by 19 months of age is a challenge nationwide. Texas has achieved the 90% goal for all vaccines in the 4:3:1:3:3:1 series with the exception of DTaP, where coverage for four doses is only 81.4%.

Objectives:
While many barriers to immunization are well-recognized, such as vaccine cost, Texas is conducting research to explore the possibility that hitherto unrecognized barriers exist to on-time DTaP immunization that are currently responsible for holding back progress in Texas. A second objective is to learn which of the identified barriers are most widely cited by parents and which parents experience as carrying the greatest weight.

Methods:
Research is being conducted in two stages: qualitative exploratory research to identify barriers and quantitative research to collect data on their prevalence and weight.
Texas is using the immunization registry to identify children less than three years of age who were not currently up to date for DTaP as of November 2007. In-depth interviews are being conducted with the parents of over 45 such children to more fully understand their experience and views.
Insights gained in this process will inform the development of a quantitative survey instrument. Drawing again on the Texas immunization registry to identify parents of children under three who are behind on DTaP immunization, the quantitative survey will collect data from a sufficiently robust number to be representative of the state. , and possibly enough to disaggregate by geographic, demographic and socioeconomic variables.

Results:
Research is currently underway and results are expected to be available by the date of the National Immunization Conference.

Conclusions:
To be added.