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Do laws bring children in child care centers up to date for immunizations?
Maureen S Kolasa1, Andrew P Chilkatowsky, John M Stevenson
1National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. mxk2@cdc.gov
Insights
Pennsylvania
Area of Science:
- Pediatric Health
- Public Health Policy
- Vaccinology
Background:
- Pennsylvania law mandates immunization records for children in child care centers (CCCs) within 60 days of enrollment.
- This study assesses the law's effectiveness in Philadelphia's CCCs for children under 59 months.
- Childhood immunizations are crucial for preventing vaccine-preventable diseases.
Purpose of the Study:
- To evaluate the impact of a Pennsylvania state law on immunization coverage in Philadelphia child care centers.
- To determine if the 60-day enrollment period for up-to-date (UTD) immunizations is being met.
- To identify age groups with the lowest immunization rates among children attending CCCs.
Main Methods:
- Randomly selected 75 child care centers (CCCs) in Philadelphia out of 440.
- Assessed vaccination records for 2847 children aged 59 months or younger.
- Collected data from CCC records, immunization registries, healthcare providers, and parents.
Main Results:
- Immunization coverage varied by age: 71% for 0-18 months, 77% for 19-35 months, and 84% for 36-59 months.
- No significant increase in immunization coverage was observed within 60 days of enrollment.
- A notable percentage of children remained not up-to-date (UTD) for routine immunizations.
Conclusions:
- Up to 25% of children under 5 in Philadelphia CCCs are not UTD on immunizations, particularly those aged 0-18 months.
- Many children do not receive required vaccines within the 60-day enrollment window.
- Children in CCCs are at increased risk for vaccine-preventable diseases due to low immunization rates and group settings.
Background:
Pennsylvania state law requires licensed child care centers (CCCs) to document that each enrolled child is up to date (UTD) for routine immunizations within 60 days of enrollment. This study evaluates the law's impact on immunization coverage among children aged
Methods:
Out of Philadelphia's 440 commercial CCCs, 75 were randomly selected. Of these, 9 had closed, 3 did not accept children aged
Results:
Records of 2847 children were assessed. According to CCC records, information from the immunization registry, vaccination providers, and parents, 71% of children aged 0-18 months, 77% of children 19-35 months, and 84% of children 36-59 months were UTD for their age for diphtheria, tetanus toxoids, and pertussis vaccine; polio; Haemophilus influenzae type b; and measles, mumps, and rubella vaccines. No significant increase in immunization coverage levels was found between the date children enrolled in a CCC and 60 days later.
Conclusions:
Up to one quarter of children <5 years of age enrolled in Philadelphia's CCCs are not UTD for immunizations, with children 0-18 months of age being most behind in their immunizations. Furthermore, many children do not receive vaccines within 60 days of enrollment. These low coverage levels combined with the potential exposures inherent in group care settings indicate that children in CCCs are at risk for contracting vaccine-preventable diseases.