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Immunization coverage in a population-based sample of Maryland children
I T Williams1, D M Dwyer, E M Hirshorn
1Department of Epidemiology, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Md.
Archives of Pediatrics & Adolescent Medicine
|April 1, 1994
Summary
While most Maryland children are vaccinated by first grade, significant delays occur before age two. Healthcare providers can improve timely childhood immunizations by administering vaccines simultaneously.
Area of Science:
- Pediatric Health
- Immunization Practices
- Public Health Surveillance
Background:
- High vaccination coverage is crucial for preventing childhood infectious diseases.
- Understanding vaccination timeliness is essential for effective public health strategies.
- School entry vaccination requirements often mask earlier delays in administration.
Purpose of the Study:
- To assess vaccination coverage and timeliness in a population-based sample of Maryland children.
- To identify delays in the administration of routine childhood vaccines.
- To evaluate the proportion of vaccines administered simultaneously.
Main Methods:
- Historical cohort study utilizing stratified cluster sampling of Maryland elementary schools.
- Analysis of immunization records for 1938 randomly selected first-grade children.
- Assessment of age of vaccine completion and simultaneous vaccine administration.
Main Results:
- 95.2% of children had complete diphtheria and tetanus toxoids and pertussis (DTP), oral poliovirus (OPV), and measles-mumps-rubella (MMR) vaccines by first grade.
- Only 54.8% achieved this coverage by 24 months of age, indicating significant delays.
- 30% of children up-to-date at age one missed a vaccine dose in their second year; only 16.2% received MMR simultaneously with DTP/OPV.
Conclusions:
- Childhood immunization levels are high at school entry but marked by substantial delays before age two.
- Vaccination delays occur across urban, suburban, and rural areas, and in public and private schools.
- Simultaneous vaccine administration by healthcare providers could improve age-appropriate vaccination timeliness.