Assessing Immunization Coverage Among Children Attending Licensed Child Care Centers, New York City 2010

Background: In 2008, New York City (NYC) Department of Health and Mental Hygiene (DOHMH) Bureau of Immunization identified the 10 zip codes (target areas) with the lowest coverage for four doses of the diphtheria, tetanus and acellular pertussis vaccine (DTaP4) among children at 2 years of age. DTaP4 coverage in the targeted areas was 71% compared to 74% citywide. The NYC 2009 National Immunization Survey (NIS) coverage for 431331 was 71.7±6.9.

Objectives: To assess immunization coverage rates of pre-school children attending licensed child care centers in the 10 targeted areas.

Methods: Licensed child care centers in the target areas registered with the NYC DOHMH Bureau of Child Care (BOCC) and the NYS Department of Health were identified. Only centers with children enrolled at time of assessment were included in the study. Records for all children <6 years of age were assessed. Coverage was assessed for DTaP4 at 2 years of age among children at least 2 years and older and for the 431331 series for children between 19-35 months. Rates were compared to citywide rates from the 2009 NIS.  

Results: 7,751 child records were assessed at 216 sites (based on the initial list provided by BOCC which represented 80% of all centers in targeted area). The median age of the children was 3.5 years (range 1-71 months). UTD status of children at time of assessment was 80%. DTaP4 coverage at 2 years of age was 76%. The UTD status of children 19-35 months for 431331 was 75.5%.

Conclusions: Children attending care centers in the targeted areas appear to be more UTD when compared to the previous assessment of the target areas as a whole and to the most recent NIS Citywide estimate, demonstrating the importance of daycare immunization requirements. Strategies need to be developed to improve coverage among pre-school children not attending childcare.