Evaluation of Oklahoma Child Care Audit Program

Background: Oklahoma Child Care Audit Program (OCCAP) evaluates the immunization coverage levels of childcare /Headstart facilities within the state. The purpose of OCCAP is to ensure all children who attend childcare /Headstart facilities are protected against vaccine preventable diseases and that childcare facilities are appropriately monitoring immunization as required by state law.  The program goal is to have a ≥ 90% immunization coverage level in all childcare/Headstart facilities.   To address the critical gaps in coverage, the Immunization Service provides 25 Immunization Field Consultants (IFCs) assigned to all 77 counties.  IFCs select daycare/Headstart facilities in their regions to audit, and work directly with the facility to determine coverage levels and teach best methods for increasing vaccine rates. 

Setting: All childcare/Headstart facilities in Oklahoma

Population: Children ages 6 weeks to 24 months in all childcare/Headstart facilities in Oklahoma

Project Description: The OCCAP helps to review immunization records and discrepancies are addressed and followed up accordingly.  In Oklahoma, childcare attendees must be up-to-date for their age according to the recommended schedule for the following vaccines and number of doses:  4 DTaP (diphtheria, tetanus & pertussis vaccine), 1-4 PCV (pneumococcal conjugate vaccine), 3 Polio, 1 MMR (measles, mumps, & rubella vaccine), 1-4 Hib (Haemophilus influenzae type B vaccine), 3 Hepatitis B, 2 Hepatitis A, and 1 Varicella (chickenpox vaccine). 

Results/Lessons Learned: For 2006-2008, OCCAP IFCs made a total of 1,955 visits to 1,369 facilities and reviewed 44,839 immunization records.  For 2007-2008, the proportion of childcare centers achieving a ≥ 90% coverage rate improved from 41.7% at the time of the initial visit to 61.7% by the last visit.  There is a one percent increase annually from 2006 to 2008.  The program is evaluated by documentation of the total visits, total records reviewed, and the total child care centers up to date.