Vaccinating My Way—Use of Alternative Vaccination Schedules in New York State - 17/10/14

Doi : 10.1016/j.jpeds.2014.09.013

Jessica A. Nadeau, PhD, MPH ¹, Robert A. Bednarczyk, PhD ^1,², Munyaradzi R. Masawi, BS ³, Megan D. Meldrum, BS ³, Loretta Santilli, MPH ³, Shelley M. Zansky, PhD ³, Debra S. Blog, MD, MPH ³, Guthrie S. Birkhead, MD, MPH ^1,³, Louise-Anne McNutt, PhD ^4,^⁎
¹ School of Public Health, State University of New York, University at Albany, Rensselaer, NY
² Rollins School of Public Health, Emory University, Atlanta, GA
³ New York State Department of Health, Albany, NY
⁴ Institute for Health and the Environment, State University of New York, University at Albany, Rensselaer, NY

^∗Reprint requests: Louise-Anne McNutt, PhD, Institute for Health and the Environment, State University of New York, University at Albany, GEC 125, 1 University Place, Rensselaer, NY 12144.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 17 October 2014

Abstract

Objective

To identify children vaccinated following an alternative vaccine schedule using immunization information system data and determine the impact of alternative schedule use on vaccine coverage.

Study design

Children born in New York State, outside New York City, between January 1, 2009 and August 14, 2011 were assessed for vaccination patterns consistent with use of an alternative schedule. Children who by 9 months of age had at least 3 vaccination visits recorded in the statewide mandatory immunization information system after 41 days of age were classified as either attempting to conform to the Centers for Disease Control and Prevention published recommended vaccination schedule or an alternative schedule. The number of vaccination visits and up-to-date status at age 9 months were compared between groups.

Results

Of the 222 628 children studied, the proportion of children following an alternative schedule was 25%. These children were significantly less likely to be up-to-date at age 9 months (15%) compared with those conforming to the routine schedule (90%, P < .05). Children following an alternative schedule on average had about 2 extra vaccine visits compared with children following a routine schedule (P < .05).

Conclusions

Almost 1 in 4 children in this study appear to be intentionally deviating from the routine schedule. Intentional deviation leads to poor vaccination coverage leaving children vulnerable to infection and increasing the potential for vaccine-preventable disease outbreaks.

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Keyword : DTaP, HepB, Hib, IPV, NYC, NYS, NYSIIS, PCV, RV

Plan

Methods

Vaccine Schedule Grouping

Assessment of Up-To-Date Status

Statistical Analyses

Results

Comparison of Routine Schedule and Alternative Schedule Vaccination Characteristics

Up-To-Date Status at 9 Months

Discussion

Supported by the Centers for Disease Control and Prevention (Cooperative Agreement U50CK000199). The acquisition of data was conducted under the auspices of the New York State Department of Health Bureau of Immunization. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the New York State Department of Health. The authors declare no conflicts of interest.