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Compliance with vaccination recommendations for U.S. children

Elizabeth T Luman1, Kate M Shaw, Shannon K Stokley

  • 1National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia 30333, USA. ECL7@cdc.gov

American Journal of Preventive Medicine
|May 13, 2008
PubMed

Insights

Official vaccination recommendations are not fully met by many U.S. children. Missed or invalid vaccine doses contribute significantly to noncompliance, impacting overall public health protection.

Area of Science:

  • Pediatric Health
  • Public Health Policy
  • Immunization Practices

Background:

  • Official vaccination schedules for U.S. children are set by the Advisory Committee on Immunization Practices (ACIP).
  • These recommendations detail vaccine types, doses, age ranges, valid dose timing, and intervals.
  • Current federal estimates primarily track dose counts, overlooking other compliance factors.

Purpose of the Study:

  • To evaluate compliance with all official vaccination recommendations, not just dose counts.
  • To determine the proportion of children noncompliant with the full set of ACIP guidelines.
  • To identify reasons for noncompliance, including missed doses and timing issues.

Main Methods:

  • Analysis of vaccination histories for 17,563 U.S. children aged 19-35 months.
  • Data sourced from the 2005 National Immunization Survey.
  • Assessment of compliance with each individual vaccination recommendation.

Main Results:

  • Overall compliance with all recommendations was 72%, 9 percentage points lower than dose-count-only estimates.
  • 19% of children missed at least one dose, 8% received an invalid dose, and 9% had other recommendation issues.
  • Reasons for noncompliance varied by state and specific vaccine antigen.

Conclusions:

  • Approximately 28% of children were not compliant with all official vaccination guidelines.
  • Missed doses accounted for about two-thirds of noncompliance; timing and other factors comprised the rest.
  • Comprehensive compliance measurement is crucial for improving healthcare quality and maximizing protection against vaccine-preventable diseases.
Abstract

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