title: Impact of the sequential poliovirus immunization schedule: a demonstration project.
abstract: OBJECTIVE
  Researchers for this project evaluated compliance with the sequential poliovirus immunization schedule that uses inactivated poliovirus vaccine (IPV) for the first 2 doses of the polio immunization series, and assessed immunization coverage rates before and after implementation of this schedule at 6 public health clinics serving 1 county in Georgia.
  
  
  METHODS
  Immunization histories for 3 birth cohorts of infants were compared: (1) the baseline cohort, born January 1 through June 30, 1995; (2) the evaluation cohort, born January 1 through June 30, 1997, after implementation of the schedule change; and (3) the dose-3 cohort, born August 1 through November 30, 1996 (i.e., old enough to be eligible for a third dose of poliovirus vaccine following implementation of the sequential schedule).
  
  
  RESULTS
  Following implementation of the new poliovirus immunization recommendations, 94% (534 of 567) of infants who received their first dose of poliovirus vaccine by age 3 months received IPV. Among these infants, 99.6% (532 of 534) were also up to date (UTD) for first doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTP1/DTaP1), 99.6% (532 of 534) were UTD for first doses of hemophilus influenza type b (Hib 1), and 98.6% (527 of 534) had received at least one dose of Hepatitis B. Among infants visiting the clinics for their first or second dose of poliovirus vaccine, DTaP/DTP, and/or Hib, 76% received 3 or 4 simultaneous injections. In the dose-3 cohort, 78% (145 of 185) of infants who received a third dose of poliovirus vaccine had received 2 doses of IPV and 1 dose of oral poliovirus vaccine.
  
  
  CONCLUSIONS
  Compliance with the recommended use of IPV for the first 2 poliovirus immunization doses as part of the sequential schedule was very high in this low-income and ethnically diverse population. Furthermore, the need for additional injections did not impede the delivery of recommended childhood immunizations.
authors.affiliation: National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. mxk2@cdc.gov
authors.forename: M S
authors.initials: MS
authors.lastname: Kolasa
authors.forename: S N
authors.initials: SN
authors.lastname: Desai
authors.forename: K M
authors.initials: KM
authors.lastname: Bisgard
authors.forename: K
authors.initials: K
authors.lastname: Dibling
authors.forename: D R
authors.initials: DR
authors.lastname: Prevots
mesh_terms: D000956:Antigens, Viral / Q000302:isolation & purification; D002662:Child Health Services / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D005845:Georgia; D006509:Hepatitis B / Q000276:immunology; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D010349:Patient Compliance; D011054:Poliovirus Vaccine, Inactivated / Q000008:administration & dosage*; D013383:Suburban Population
chemical_list: D000956:Antigens, Viral; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D011054:Poliovirus Vaccine, Inactivated