title: Protecting Texas children: evidence-based recommendations for improving childhood vaccination rates.
abstract: Currently, Texas ranks in the bottom quintile of states for childhood vaccinations. Approximately, one fourth of Texas children younger than age 3 years have not received the recommended full schedule of vaccinations. Such a low rate can produce serious health consequences by reducing "community immunity." We review the current literature on barriers to high immunization rates and on effective, evidence-based strategies and programs. In addition, we report the results of interviews with public health officials responsible for implementing immunization programs in Texas and in a sample of high-ranking states for their assessment of the most effective strategies. We suggest legislative and administrative changes for Texas on the basis of the literature review and interview results. These recommendations involve improving the public health network, strengthening financial and administrative incentives to providers, enhancing incentives for parents, and encouraging federal program modifications.
authors.affiliation: Department of Political Science, Box 41015, Texas Tech University, Lubbock, TX 79409-1015, USA.
authors.forename: Clarke E
authors.initials: CE
authors.lastname: Cochran
authors.forename: David R
authors.initials: DR
authors.lastname: Smith
authors.forename: Glen
authors.initials: G
authors.lastname: Reid
authors.forename: Helen
authors.initials: H
authors.lastname: Morrow
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ramirez
mesh_terms: D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D006297:Health Services Accessibility; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007223:Infant; D013781:Texas; D014611:Vaccination / Q000706:statistics & numerical data*