 |
|
Extraimmunization Among US Children
Suzanne M. Feikema, MHA;
R. Monina Klevens, DDS, MPH;
Michael L. Washington, PhD;
Lawrence Barker, PhD
JAMA. 2000;283:1311-1317.
Context Little is known about the extent of extraimmunization, ie, vaccine doses given in excess of the recommended schedule, and whether it should be a public health concern.
Objectives To determine the extent and cost of extraimmunization in children and to identify its associated factors.
Design, Setting, and Participants United States 1997 National Immunization Survey, in which telephone interviews were conducted with parents of 32,742 19- to 35-month-old children and vaccination histories were collected from health care providers for 22,806 of these children (overall response rate, 68.5%). Estimates were weighted to represent the full sample.
Main Outcome Measures Frequency of extraimmunization compared by vaccine type as well as with adequate immunization; factors associated with extraimmunization; and vaccine and visit costs associated with extraimmunization.
Results Frequency of extraimmunization was less than 5% for each vaccine considered except poliovirus (14.1%). Overall, 21% of children were extraimmunized for at least 1 vaccine vs 31% underimmunized for at least 1 vaccine. In a multivariate model, the strongest contributors to extraimmunization were having more than 1 immunization provider (odds ratio [OR], 2.8; 95% confidence interval [CI], 2.4-3.2) and having multiple types of providers (eg, private and public health department; OR, 2.0; 95% CI, 1.6-2.4). Children seen only in public health department clinics were significantly less likely to be extraimmunized (OR, 0.3; 95% CI, 0.2-0.3). Annual costs associated with extraimmunization for this cohort of children were estimated conservatively at $26.5 million.
Conclusions These data indicate that extraimmunization can be costly. The challenge is to reduce extraimmunization without interfering with more important efforts to combat underimmunization. Improvements in immunization record keeping and sharing practices may help reduce extraimmunization.
Author Affiliations: Medical Management Department, Children's Healthcare of Atlanta (Ms Feikema); and Assessment Branch (Dr Klevens) and Statistical Analysis Branch (Drs Washington and Barker), Data Management Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
The Success of an Immunization Information System in the Wake of Hurricane Katrina
Boom et al.
Pediatrics 2007;119:1213-1217.
ABSTRACT
| FULL TEXT
Medication errors in paediatric care: a systematic review of epidemiology and an evaluation of evidence supporting reduction strategy recommendations
Miller et al.
Qual Saf Health Care 2007;16:116-126.
ABSTRACT
| FULL TEXT
Measuring Immunization Coverage among Preschool Children: Past, Present, and Future Opportunities
Salmon et al.
Epidemiol Rev 2006;28:27-40.
ABSTRACT
| FULL TEXT
Compliance With National Immunization Guidelines for Children Younger Than 2 Years, 1996-1999
Mell et al.
Pediatrics 2005;115:461-467.
ABSTRACT
| FULL TEXT
Immunization Coverage of Vulnerable Children: A Comparison of Health Center and National Rates
Schempf et al.
Med Care Res Rev 2003;60:85-100.
ABSTRACT
Polio Extraimmunization in Children Younger Than 2 Years After Changes in Immunization Recommendations
Mell et al.
Pediatrics 2003;111:296-301.
ABSTRACT
| FULL TEXT
Timeliness of Childhood Immunizations
Luman et al.
Pediatrics 2002;110:935-939.
ABSTRACT
| FULL TEXT
Extraimmunization in Children Through 2000
Strine et al.
JAMA 2002;287:588-589.
FULL TEXT
Progress in Development of Immunization Registries--United States, 2000
JAMA 2001;285:529-530.
FULL TEXT
The Impact of Record Scattering on the Measurement of Immunization Coverage
Stokley et al.
Pediatrics 2001;107:91-96.
ABSTRACT
| FULL TEXT
Vaccine Extraimmunization--Too Much of a Good Thing?
Davis
JAMA 2000;283:1339-1340.
FULL TEXT
|
