title: Vaccination levels and missed opportunities for measles vaccination: a record audit in a public pediatric clinic.
abstract: A record audit of 254 children attending a public clinic in Los Angeles was conducted to assess immunization levels prior to a measles outbreak in the community. Coverage with all vaccines appropriate for age decreased from 67% at 3 months to 25% at 19 months. Delay in initiating vaccination was associated with increasing risk for delayed measles-mumps-rubella vaccine beyond age 2 years (P less than .05). In one third of children, health care providers missed an opportunity to administer measles-mumps-rubella vaccine. Recall systems and elimination of missed opportunities may increase vaccination levels in clinic populations. Record audits should be considered for use in guiding the management of immunization programs.
authors.affiliation: Division of Immunization, Centers for Disease Control, Atlanta, GA 30333.
authors.forename: K M
authors.initials: KM
authors.lastname: Farizo
authors.forename: P A
authors.initials: PA
authors.lastname: Stehr-Green
authors.forename: L E
authors.initials: LE
authors.lastname: Markowitz
authors.forename: P A
authors.initials: PA
authors.lastname: Patriarca
mesh_terms: D000367:Age Factors; D001424:Bacterial Infections; D002675:Child, Preschool; D003191:Comprehensive Health Care; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D005334:Fever; D006268:Health Facilities; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D015141:Los Angeles / Q000453:epidemiology; D008458:Measles Vaccine / Q000008:administration & dosage; D008485:Medical Audit; D009108:Mumps Vaccine / Q000008:administration & dosage; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage; D012189:Retrospective Studies; D012307:Risk Factors; D012411:Rubella Vaccine / Q000008:administration & dosage; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D008458:Measles Vaccine; D009108:Mumps Vaccine; D011055:Poliovirus Vaccine, Oral; D012411:Rubella Vaccine