This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Davis, R. L.
Right arrow Articles by Rodewald, L. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Davis, R. L.
Right arrow Articles by Rodewald, L. E.
Related Collections
Right arrow Infectious Disease & Immunity
Right arrowRelated AAP Red Book topics:
Poliovirus Infections
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 107 No. 4 April 2001, pp. 671-676

Impact of the Change in Polio Vaccination Schedule on Immunization Coverage Rates: A Study in Two Large Health Maintenance Organizations

Received Jun 6, 2000; accepted Aug 30, 2000.

Robert L. Davis*, Dagger , , Tracy A. Lieu§, parallel , Loren K. Mell*, Angela M. Capra§, Ann Zavitkovsky*, Charles P. Quesenberry Jr.§, Steven B. Black§, Henry R. Shinefield§, Robert S. Thompson*, and Lance E. Rodewald#

From the * Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington; Dagger  Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington; § Division of Research, Kaiser Permanente of Northern California, Oakland, California; parallel  Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston, Massachusetts;  Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington; and # National Immunization Program, Division of Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia.

Objective.  In January 1997, one of the most significant changes to United States vaccine policy occurred when polio immunization guidelines changed to recommend a schedule containing inactivated polio vaccine (IPV). There were concerns that parent or physician reluctance to accept IPV into the routine childhood immunization schedule would lead to lowered coverage. We determined whether adoption of an IPV schedule had a negative impact on immunization coverage.

Design.  A cohort study of 2 large health maintenance organizations (HMOs), Group Health Cooperative and Kaiser Permanente Northern California, was conducted. For analysis at 12 months of age, children who were born between October 1, 1996, and December 31, 1997, and were commercially insured and covered by Medicaid were continuously enrolled; for analysis at 24 months of age, children who were born between October 1, 1996, and June 30, 1997, and were commercially insured and covered by Medicaid were continuously enrolled. The 3 measures of immunization status at 12 and 24 months of age were up-to-date status, cumulative time spent up-to-date, and the number of missed opportunity visits.

Results.  At both HMOs, children who received IPV were as likely to be up to date at 12 months as were children who received oral poliovirus vaccine (OPV), whereas at Group Health, children who received IPV were slightly more likely to be up to date at 24 months (relative risk: 1.12; 95% confidence interval [CI]: 1.05, 1.19). These findings were consistent for children who were covered by Medicaid. At Kaiser Permanente, children who received IPV spent ~3 fewer days up to date in the first year of life, but this difference did not persist at 2 years of age. At Group Health, children who received IPV were no different from those who received OPV in terms of days spent up to date by 1 or 2 years of age. At Group Health, children who received IPV were less likely to have a missed opportunity by 12 months old (odds ratio [OR] 0.46; 95% CI: 0.31, 0.70), but this finding did not persist at 24 months of age. At Kaiser Permanente, children who received IPV were more likely to have a missed opportunity by 12 months (OR 2.06; 95% CI: 1.84, 2.30), and 24 months of age (OR 1.50; 95% CI: 1.36, 1.67).

Conclusions.  The changeover from an all-OPV schedule to one containing IPV had little if any negative impact on vaccine coverage. Use of IPV was associated with a small increase in the likelihood of being up to date at 2 years of age at one of the HMOs and conversely was associated with a small increase in the likelihood of having a missed-opportunity visit in the other HMO.polio, poliomyelitis, vaccination, immunization coverage. .


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 PediatricsHome page
P. G. Szilagyi, M. R. Griffin, L. P. Shone, R. Barth, Y. Zhu, S. Schaffer, S. Ambrose, J. Roy, K. A. Poehling, K. M. Edwards, et al.
The Impact of Conjugate Pneumococcal Vaccination on Routine Childhood Vaccination and Primary Care Use in 2 Counties
Pediatrics, October 1, 2006; 118(4): 1394 - 1402.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. H. Glauber
The Immunization Delivery Effectiveness Assessment Score: A Better Immunization Measure?
Pediatrics, July 1, 2003; 112(1): e39 - 45.
[Abstract] [Full Text] [PDF]

Home page
 AAP NewsHome page

AAP News, June 1, 2001; 18(6): 246 - 246.
[Full Text] [PDF]