Article

Frequency of Alternative Immunization Schedule Use in a Metropolitan Area

Oregon Immunization Program, Oregon Health Authority, Portland, Oregon 97008, USA.
PEDIATRICS (Impact Factor: 5.47). 06/2012; 130(1):32-8. DOI: 10.1542/peds.2011-3154
Source: PubMed

ABSTRACT

Recent studies have described an increase in parental hesitancy regarding vaccines as well as increases in parental adoption of vaccine schedules that delay or limit receipt of recommended vaccines. This study quantifies potential prevalence and trends in alternative schedule compliance by measuring consistent shot-limiting in a metropolitan area of Oregon.
Retrospective cohort analysis using the Oregon ALERT Immunization Information System to track children born between 2003 and 2009 in the Portland metropolitan area. Joinpoint regression was used to analyze prevalence trends in consistent shot-limiting during that time period. The 2007-2009 Haemophilus influenzae type b vaccine shortage and increased availability of combination vaccines were also examined for their effects on shot-limiting rates.
A total of 4502 of 97,711 (4.6%) children met the definition of consistent shot-limiters. The proportion of consistent shot-limiters in the population increased from 2.5% to 9.5% between 2006 and 2009. Compared with those with no or episodic limiting, consistent shot-limiters by 9 months of age had fewer injections (6.4 vs 10.4) but more visits when immunizations were administered (4.2 vs 3.3). However, only a small minority of shot-limiters closely adhered to published alternative schedules.
The percentage of children consistently receiving 2 or fewer vaccine injections per visit between birth and age 9 months increased threefold within a 2-year period, suggesting an increase in acceptance of non-Advisory Committee on Immunization Practices vaccine schedules in this geographic area.

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    • "Although the campaign was conducted with reference to the geographical community of Fremantle and the broader lifestyle that this Fremantle identity connotes, our findings are potentially applicable to other similar communities, particularly because we did not limit survey responses to Fremantle residents only. There are isolated " Fremantle-type " individuals throughout broader populations , connected by online and social media, and there are other communities with apparent similarities to Fremantle in terms of lifestyle and values, with Portland in the USA [41] [42] a popularly referenced example. While similarities between national and international 'hesitant communities' need to be mapped and crossnational virtual 'hesitant communities' also require investigation, we hope our strategy and limited findings will help researchers in those settings develop and test new ideas. "
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    • "Previous work has shown that the V64.05 and V64.06 ICD-9-CM codes are highly specific for intentional parental delay or refusal of childhood vaccination [10]. Children identified as being on a known alternative schedule had a vaccination pattern consistent with the alternative and selective schedules described in The Vaccine Book [20], were consistent shot-limiters [6], delayed starting all vaccinations until past four months, or were completely unvaccinated. Vaccination status was assessed at the end of followup for children whose follow-up ended between ages 12 and 23 months. "
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