A'barrier-Free'health care system does not ensure adequate vaccination of 2-year-old children.
To assess vaccination status in a cohort of 2 year olds with access to health care at no cost and to delineate factors associated with failure to be fully vaccinated.
Retrospective cross-sectional study.
Children not up-to-date on vaccinations by age 2 years compared with children up-to-date by medical record review.
A telephone survey was conducted for those without medical records or whose records lacked complete documentation.
Large military tertiary care hospital.
A cohort of 844 children born between August 31,1988, and September 1,1989.
Main Outcome Measures
Timeliness of vaccination, factors associated with undervaccination, number and nature of missed opportunities.
Best estimate of coverage with entire primary vaccination series was 72% by age 2 years.
Attendance at military day care was associated with full vaccination (odds ratio [OR]=1.80, confidence interval [CI]=1.12 to 3.24) as was completion of well-baby visits.
Increasing number of other visits did not predict full vaccination.
Children followed up by family practice were more likely to be up-to-date than children followed up by pediatrics (OR=3.67, CI=1.47 to 9.73).
Seventy-two percent of children who were not up-to-date had at least one missed opportunity for vaccination.
Offering free vaccinations in a « barrier-free » system will not ensure vaccination levels of 90%.
Mots-clés Pascal : Vaccination, Système santé, Calendrier vaccination, Observance thérapeutique, Etats Unis, Immunoprophylaxie, Nourrisson, Enfant, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : Vaccination, Health system, Vaccination schedule, Treatment compliance, United States, Immunoprophylaxis, Infant, Child, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0565661
Code Inist : 002B30A03B. Création : 01/03/1996.