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May 1991, Vol 145, No. 5 >
Article | May 1991

What Will It Take to Fully Protect All American Children With Vaccines? FREE

Alan R. Hinman, MD, MPH
[+] Author Affiliations

Accepted for publication December 27, 1990.

Reprints not available.


Am J Dis Child. 1991;145(5):559-562. doi:10.1001/archpedi.1991.02160050085023.
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• Although 95% of children have had a full course of vaccines by the time they enter school, immunization levels among poor inner-city preschoolers may be substantially lower. Among the factors responsible for the disparity are the lack of a uniform data system to identify children who need vaccine; missed opportunities to offer immunizations; overinterpretation of contraindications; and administrative barriers to immunization. Remedies lie in a multifaceted approach: a tracking system that will prompt a reminder and then sound an alarm when an immunization is overdue; means of informing parents, probably best accomplished by an outreach worker of the same racial or ethnic background as the parent; removal of administrative barriers and increased access to services; incentives, either positive or negative, to raise the priority of immunizations; and more education for health care providers to ensure that they understand contraindications and do not miss opportunities to offer vaccines. Other possibilities are "express lane" services to immunize all children who come to a health care provider and the delivery of immunizations in child care settings and in programs such as Women, Infants, and Children, and Aid to Families With Dependent Children.

(AJDC. 1991;145:559-562)

REFERENCES

1 +
Centers for Disease Control.  General recommendations on immunization . MMWR . 1989;;38:205-214, 219-227.
2 +
American Academy of Pediatrics, Committee on Infectious Diseases.  Measles . Pediatrics . 1989;;84:1110-1113.
3 +
Orenstein WA, Bernier RH.  Surveillance . Pediatr Clin North Am . 1990;;37:709-734.
4 +
Centers for Disease Control.  Measles vaccination levels among preschool-aged children in 8 selected cities, United States . MMWR . 1991;;40:36-39.
5 +
Centers for Disease Control.  Update: measles outbreak—Chicago, 1989 . MMWR . 1990;:39:317-319, 325-326.
6 +
Ector WL. Immunization levels of children in private practice. In: Proceedings of the 15th Immunization Conference of the Centers for Disease Control; March 10-13, 1980; Denver, Colo; pp 70-72.
7 +
Dawson DA, Cain VS. Child care arrangements: health of our nation's children, United States, 1988. Advance data No. 187. Hyattsville, Md; National Center for Health Statistics; 1990.
8 +
Orenstein WA, Atkinson W, Mason D, Bernier RH.  Barriers to vaccination of preschool children . J Health Care Poor Underserved . 1990;;1:315-329.
Link to Article
9 +
Bruce R. Status and use of vaccine information pamphlets. In: Proceedings of the 24th National Immunization Conference of the Centers for Disease Control; May 21-25, 1990; Orlando, Fla; pp 99-100.
10 +
Arouet FM (Voltaire). Dictionnaire Philosophique. 1764.
11 +
Bloom B. Health insurance and medical care: health of our nation's children, United States, 1988. Advance data No. 188. Hyattsville, Md: National Center for Health Statistics; 1990.
12 +
Health Insurance Association of America Survey 1989 . Washington, DC: Health Insurance Association of America; 1989;.
13 +
American Academy of Pediatrics. Cross-national comparisons of child health. Pediatrics. In press.
14 +
Hutchins SS. Access of preschool-aged children to health care services and federal assistance programs. In: Proceedings of the 24th National Immunization Conference of the Centers for Disease Control; May 21-25, 1990; Orlando, Fla; pp 87-92.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Centers for Disease Control.  General recommendations on immunization . MMWR . 1989;;38:205-214, 219-227.
2 +
American Academy of Pediatrics, Committee on Infectious Diseases.  Measles . Pediatrics . 1989;;84:1110-1113.
3 +
Orenstein WA, Bernier RH.  Surveillance . Pediatr Clin North Am . 1990;;37:709-734.
4 +
Centers for Disease Control.  Measles vaccination levels among preschool-aged children in 8 selected cities, United States . MMWR . 1991;;40:36-39.
5 +
Centers for Disease Control.  Update: measles outbreak—Chicago, 1989 . MMWR . 1990;:39:317-319, 325-326.
6 +
Ector WL. Immunization levels of children in private practice. In: Proceedings of the 15th Immunization Conference of the Centers for Disease Control; March 10-13, 1980; Denver, Colo; pp 70-72.
7 +
Dawson DA, Cain VS. Child care arrangements: health of our nation's children, United States, 1988. Advance data No. 187. Hyattsville, Md; National Center for Health Statistics; 1990.
8 +
Orenstein WA, Atkinson W, Mason D, Bernier RH.  Barriers to vaccination of preschool children . J Health Care Poor Underserved . 1990;;1:315-329.
Link to Article
9 +
Bruce R. Status and use of vaccine information pamphlets. In: Proceedings of the 24th National Immunization Conference of the Centers for Disease Control; May 21-25, 1990; Orlando, Fla; pp 99-100.
10 +
Arouet FM (Voltaire). Dictionnaire Philosophique. 1764.
11 +
Bloom B. Health insurance and medical care: health of our nation's children, United States, 1988. Advance data No. 188. Hyattsville, Md: National Center for Health Statistics; 1990.
12 +
Health Insurance Association of America Survey 1989 . Washington, DC: Health Insurance Association of America; 1989;.
13 +
American Academy of Pediatrics. Cross-national comparisons of child health. Pediatrics. In press.
14 +
Hutchins SS. Access of preschool-aged children to health care services and federal assistance programs. In: Proceedings of the 24th National Immunization Conference of the Centers for Disease Control; May 21-25, 1990; Orlando, Fla; pp 87-92.

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