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To the Editor: Extraimmunization is the receipt by a child of at least 1 vaccine dose in excess of Advisory Committee on Immunization Practices recommendations. In the only published national-level study of extraimmunization in the United States, Feikema et al¹ found that, in 1997, 21.1% (95% confidence interval [CI], 20.2%-22.0%) of US children aged 19 to 35 months were extraimmunized with at least 1 antigen; this represented approximately 1 839 107 unnecessary doses. This estimate obviously affects perception of the efficiency with which immunizations are administered. Extraimmunization represents wasted vaccine, money, and time, as well as unnecessary discomfort and increased risk of adverse reactions.

The analysis by Feikema et al used 1997 data from the National Immunization Survey (NIS), a complex national survey of households with children aged 19 to 35 months, with immunization histories collected from their health care providers. After that publication, several changes were made in the NIS methodology. . . . [Full Text of this Article]

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