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Delays in receipt of immunizations in low-birth-weight children: a nationally representative sample
D L Langkamp1, S Hoshaw-Woodard, M E Boye
1Children's Hospital, Room H310, 700 Children's Dr, Columbus, OH 43205, USA. dlangkam@chi.osu.edu
Insights
Very low-birth-weight (VLBW) children experience significant delays in routine immunizations compared to normal-birth-weight infants. These VLBW infants are less likely to be up-to-date on vaccinations at 12, 24, and 36 months of age.
Area of Science:
- Pediatrics
- Public Health
- Neonatal Care
Background:
- Studies indicate potential delays in routine childhood immunizations for very low-birth-weight (VLBW) infants post-neonatal intensive care unit discharge.
- Conflicting findings exist, with some studies showing no significant immunization delays in VLBW populations within specific healthcare systems.
Purpose of the Study:
- To evaluate the risk of immunization delays in moderately low-birth-weight (MLBW) and VLBW infants compared to normal-birth-weight infants.
- To analyze immunization timeliness using a nationally representative birth cohort.
Main Methods:
- Utilized logistic regression analysis with data from the 1988 National Maternal and Infant Health Survey and its 1991 Longitudinal Follow-up Survey.
- Included a nationally representative sample of 8,285 children born in the United States in 1988.
- Assessed age at receipt of specific vaccine doses (DTaP, Polio, MMR) and immunization status at 12, 24, and 36 months by birth weight.
Main Results:
- VLBW infants demonstrated significantly later receipt of initial DTaP and polio vaccine doses compared to normal-birth-weight infants (P <.001).
- VLBW children were substantially less likely to be up-to-date on all immunizations at 12 months (OR=.556), 24 months (OR=.439), and 36 months (OR=.446).
Conclusions:
- Very low-birth-weight infants face a heightened risk of experiencing delays in receiving recommended childhood immunizations.
- Findings underscore the importance of monitoring and ensuring timely vaccination for VLBW populations to achieve full immunization coverage.
Background:
Studies of very low-birth-weight (VLBW) children discharged from neonatal intensive care units have shown delays in receipt of routine childhood immunizations. However, a recent study of VLBW children in 3 health maintenance organizations found no significant delays in immunizations.
Objective:
To assess the risk of immunization delays for moderately low-birth-weight (MLBW; 1500 g-2499 g) and VLBW (<1500 g) children compared with normal-birth-weight children in a nationally representative birth sample.
Design:
Logistic regression analysis using the 1988 National Maternal and Infant Health Survey and the 1991 Longitudinal Follow-up Survey.
Setting:
Nationally representative sample of children born in 1988 in the United States.
Participants:
A total of 8285 children whose mothers completed both surveys.
Main Outcome Measures:
Age at receipt of each of the first 4 doses of diphtheria and tetanus toxoids and pertussis vaccine, the first 3 doses of polio vaccine, and the first dose of measles-mumps-rubella vaccine for MLBW and VLBW children, and normal-birth-weight children. We also examined whether children were up-to-date for all immunizations at ages 12, 24, and 36 months based on birth-weight groups.
Results:
Very low-birth-weight children received their first 3 doses of diphtheria and tetanus toxoids and pertussis vaccine and their first 2 doses of polio vaccine significantly later than normal-birth-weight children (P <.001). Very low-birth-weight children were significantly less likely to be up to date for all immunizations at ages 12 months (odds ratio [OR] =.556; P =.001), 24 months (OR =.439; P <.001), and 36 months (OR =.446; P <.001) compared with normal-birth-weight children.
Conclusion:
Very low-birth-weight children are at risk for immunization delays compared with normal-birth-weight children.