Closing of a High Volume Immunization Clinic – Impact on Coverage Among Client Children

Background: Little is known about the impact that closing an immunization clinic has on immunization coverage of children who had attended that clinic.  In Philadelphia, a high-volume childhood immunization clinic closed in September 2007.

Objectives: Assess impact of closing a high-volume childhood immunization clinic.

Methods:  Eligible children were those born March 1, 2005 – June 30, 2007, present in the Philadelphia’s Kids Immunization DatabaseTracking System (KIDS), and receiving their last KIDS-recorded immunization at the immunization clinic.  KIDS-recorded immunization coverage through January 2010 was compared between clinic children age-eligible to receive specific vaccines before clinic closing (pre-closure children) to children not age-eligible to receive those vaccines prior to closing (post-closure children). 

Results:   630 children had their last KIDS-recorded vaccination in the clinic, were <19 months when the clinic closed, and had not received all vaccines due by age 19 months.  Of these, 99 (16%) had no additional KIDS-recorded immunizations, 400 (63%) received vaccinations at one new provider, 104 (17%) at two new providers, and 27 (4%) at >three new providers.  Average monthly coverage for DTaP3 vaccination at age 7 months was 55.4% (42.0%-67.5% range) among pre-closure children compared to an average 40.8% (34.78%-45.95% range) among post-closure children.  Average coverage for MMR vaccination at 16 months was 79.42% (72.34%-88.89% range) among pre-closure children as compared to 70.34% (average, 58.49%-90.00%range) among post-closure children.  Coverage for the 431331 vaccination series at age 19 months averaged 64.09% (48.89%-74.00% range) among pre-closure children as compared to 54.31% (37.25%-75.00% range) among post-closure children.

Conclusions:  Many children had no further vaccinations recorded in KIDS after clinic closure.  While most children found new medical homes, age-appropriate coverage for recommended vaccines lagged behind coverage levels of children age-eligible to receive these vaccines before clinic closure.  When vaccination providers close, efforts must be made to ensure children are being transferred to another clinic and assist if needed.