title: Risk factors for delay in age-appropriate vaccination.
abstract: OBJECTIVE
  To estimate the risk factors of children experiencing delay in age-appropriate vaccination using a nationally representative population of children, and to compare risk factors for vaccination delay with those based on up-to-date vaccination status models.
  
  
  METHODS
  The authors compared predictors of delay in age-appropriate vaccination with those for children who were not up-to-date, using a nationally representative sample of children from five years of pooled data (1992-1996) from the National Health Interview Survey (NHIS) Immunization Supplement. Duration of delay was calculated for the DTP4, Polio3, MMR1 doses and 4:3:1 series using age-appropriate vaccination standards; up-to-date status (i.e., whether or not a dose was received) was also determined. Adjusted odds ratios were estimated using multivariate logistic regression for models of vaccination delay and up-to-date vaccination status.
  
  
  RESULTS
  Absence of a two-parent household, large family size, parental education, Medicaid enrollment, absence of a usual provider, no insurance coverage, and households without a telephone were significantly related to increased odds of a child experiencing vaccination delay (p < or = 0.05).
  
  
  CONCLUSIONS
  Many of the risk factors observed in models of vaccination delay were not found to be significant in risk models based upon up-to-date status. Consequently, risk models of delays in age-appropriate vaccination may foster identification of children at increased risk for inadequate vaccination. Populations at increased risk of inadequate vaccination can be more clearly identified through risk models of delays in age-appropriate vaccination.
authors.affiliation: Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan, 300 N. Ingalls, Rm. 6C11, Ann Arbor, MI 48109-0456, USA. kid@med.umich.edu
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Dombkowski
authors.forename: Paula M
authors.initials: PM
authors.lastname: Lantz
authors.forename: Gary L
authors.initials: GL
authors.lastname: Freed
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D004493:Education; D005191:Family Characteristics; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D008484:Medicaid; D016017:Odds Ratio; D010290:Parents; D023321:Poliovirus Vaccines / Q000008:administration & dosage; D012307:Risk Factors; D013689:Telephone; D013997:Time Factors; D014611:Vaccination
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D023321:Poliovirus Vaccines