Underimmunization in Chicago children who dropped out of WIC.
BACKGROUND
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) serves a large proportion of Chicago infants, but some discontinue participation before age 1 year. To determine if children who remained active at WIC immunization-linked sites after their first birthday were more likely to be immunized by ages 19 and 25 months than those who dropped out, a retrospective cohort study was conducted.


METHODS
Four Chicago WIC sites that used monthly voucher pick-up were chosen. Children born from July 1, 1997 to September 30, 1997 who attended these sites were eligible (N=1142). The cohort was divided into two groups: (1) active group (46%), who had a WIC visit on or after their first birthday; and (2) inactive group (54%), who had their last WIC visit before their first birthday. Children were enrolled through home visits.


RESULTS
The records for 200 children were analyzed. By age 19 months, 65 (84%) of 77 active children had received one dose of measles-mumps-rubella vaccine (MMR), compared to 82 (67%) of 123 inactive children (risk ratio [RR]=1.3; 95% confidence interval [CI], 1.1- 1.5). By age 25 months, 64 (83%) active children had received four doses of diphtheria-tetanus-pertussis vaccine (DTP), one MMR, and three doses of Haemophilus influenzae type b vaccine (Hib), compared with 64 (52%) inactive children (RR=1.6; 95% CI, 1.3-2.0).


CONCLUSIONS
In this cohort, children active in WIC after their first birthday were more likely to be immunized by ages 19 and 25 months, compared with those who were no longer active. Chicago children who drop out of WIC may represent those at highest risk for underimmunization and may require special strategies to improve coverage.
Cortese
Margaret M
MM
Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. mcortese@cdc.gov
Diaz
Pamela S
PS
Samala
Usha
U
Mennone
John Z
JZ
Mihalek
Edward F
EF
Matuck
Michael J
MJ
Johnson-Partlow
Thomasine
T
Dicker
Richard C
RC
Paul
William S
WS
D016667:Bacterial Capsules; D002641:Chicago; D002675:Child, Preschool; D015331:Cohort Studies; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D018073:Haemophilus Vaccines / Q000008:administration & dosage; D006302:Health Services Research; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D008430:Maternal-Child Health Centers / Q000706:statistics & numerical data*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D011135:Polysaccharides, Bacterial / Q000008:administration & dosage
D015721:Diphtheria-Tetanus-Pertussis Vaccine; D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D022542:Measles-Mumps-Rubella Vaccine; D011135:Polysaccharides, Bacterial