Cuyahoga County Childhood Immunization Survey: a Retrospective Survey of Kindergarten Children 2007-2008

Background:
The goal of the kindergarten retrospective survey is to determine geographic areas in Cuyahoga County with low up-to-date vaccination coverage. Past studies were performed by entering the kindergarten children's vaccine records into Clinic Assessment Software Application (CASA) to calculate the child's up-to-date status. The data was then entered into Sudaan 9.0 to determine the percentage of children who were up-to-date. During the 2007-2008 school year, the kindergarten survey was redesigned to capture additional records, to reflect more accurate results. In addition to the design study change, the computer software switched to CoCASA (Comprehensive Clinic Assessment Software Application).

Setting:
The study was conducted in an urban county in Ohio, including the City of Cleveland.

Population:
A total of 189 public and 10 private kindergartens located in Cuyahoga County participated in the survey.

Project Description:
If a school had less than 50 students all students were sampled; for schools with 51-100 kindergartners 50 was divided by the number of classrooms and this number was rounded up to determine the number of kindergarteners sampled per classroom; and for a school with more than 100 kindergartners the total number kindergarteners was divided by 2 to determine the number of kindergarteners sampled.

Results/Lessons Learned:
The difficulty with the study was the amount of time contacting each school and calculating the number of children to be sampled, in addition to entering the data. After the data was entered into CoCASA it was determined the program did not have the same capacity to analyze the data as CASA. Four reports were generated for each school in CoCASA and these results were used to calculate the weighted estimates of vaccination coverage. The methodology utilized was found in the 1995 Centers for Disease Control and Prevention publication titled Assessing Vaccination Levels of the 2-year-old Population: Guidelines."