Faculty Collaboration Database

Do missed opportunities stay missed? A 6-month follow-up of missed vaccine opportunities in inner city Milwaukee children. Pediatrics 1998 May;101(5):E5

Date

05/13/1998

Pubmed ID

9565438

DOI

10.1542/peds.101.5.e5

Scopus ID

2-s2.0-0032066254 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

OBJECTIVES: To determine 1) the frequency of missed vaccine opportunities (VOs) in inner city children </=3 years of age; 2) whether the recommended vaccine(s) were given within 6 months of the missed opportunity (MO); 3) whether these vaccinations were age-appropriate according to the guidelines of the Advisory Committee on Immunization Practices; and 4) variables associated with MOs.

DESIGN: Retrospective chart review with a nested retrospective cohort of children with MOs.

SETTING: Two inner city practice settings in Milwaukee: a community health center and an academic continuity care practice. PATIENTS/SELECTION PROCEDURE: A consecutive sample of 710 visits of inner city children </=3 years of age with VOs, seen between January 1 and March 31, 1995. A VO was defined as any encounter when the child was vaccine-eligible according to Advisory Committee on Immunization Practices guidelines.

RESULTS: MOs occurred in 47% (330/710) of the VOs. Only 40% of the children with MOs received age-appropriate immunizations within 6 months; 30% received the vaccinations beyond the age-appropriate time. The remaining 30% either did not return or were not vaccinated on return. The variables significantly associated with MOs were 1) age: children with MOs were older than those without, with a mean age of 15.5 months vs 10.9 months; 2) minor febrile illness; 3) moderate/severe illness; 4) acute illness encounters; and 5) patient's being seen at the community health center. Only 15.5% of all MOs were justified by the presence of moderate/severe illness.

CONCLUSIONS: VOs are frequently missed in inner city children. Most of the MOs were not justified by the valid contraindication of moderate/severe illness. Sixty percent of the children with MOs did not receive age-appropriate immunizations within 6 months. These children are vulnerable to vaccine-preventable diseases such as measles and pertussis.

Author List

Sabnis SS, Pomeranz AJ, Lye PS, Amateau MM

MESH terms used to index this publication - Major topics in bold

Child, Preschool
Contraindications
Follow-Up Studies
Health Services Accessibility
Humans
Immunization Schedule
Infant
Logistic Models
Minnesota
Poverty Areas
Retrospective Studies
Urban Population
Vaccination