title: Feasibility of influenza immunization for inner-city children aged 6 to 23 months.
abstract: BACKGROUND
  Annual influenza-related hospitalization rates of children aged < 2 years in the United States are second only to those of the elderly. Yet no recommendations existed for vaccinating healthy children aged 6 to 23 months until 2002, when the Advisory Committee on Immunization Practices encouraged influenza vaccination for them. This study tested the feasibility of vaccinating 6- to 23-month-old children against influenza and assessed the effect on timely receipt of other vaccines.
  
  
  METHODS
  A pre-post trial was used in urban health centers serving low-income children. Sites selected interventions from strategies proven to increase vaccination rates. Targeted patients were aged 6 to 23 months by November 30, 2002 (N = 1534).
  
  
  RESULTS
  Influenza vaccination rates for the 2002-2003 intervention season improved significantly from 6.5% to 38.5% for the first dose (p < 0.001). Second-dose rates were significantly improved over preintervention (1.9% preintervention, 13.2% intervention), but lower than first-dose rates. Mean ages at vaccination for other recommended childhood vaccines did not differ or were significantly younger (measles, mumps, and rubella vaccine [MMR] and varicella) for children who received influenza vaccine versus those who did not. Moreover, a higher percentage of influenza-vaccinated than unvaccinated children received MMR, diphtheria, tetanus, pertussis vaccine 3 (DTaP3), inactivated poliovirus vaccine 2 (IPV2), and Haemophilus influenzae b (Hib2) vaccines within a 2-month grace period of the recommended age (p < 0.039), with no differences between groups for Hib1, DTaP1, IPV1, and varicella.
  
  
  CONCLUSIONS
  With directed effort, it is possible to increase influenza vaccination at health centers serving low-income children. The addition of a two-dose vaccine was not associated with delayed receipt of other vaccines among these children.
authors.affiliation: Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA. zimmer@pitt.edu
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hoberman
authors.forename: Mary Patricia
authors.initials: MP
authors.lastname: Nowalk
authors.forename: Chyongchiou J
authors.initials: CJ
authors.lastname: Lin
authors.forename: David P
authors.initials: DP
authors.lastname: Greenberg
authors.forename: Stuart T
authors.initials: ST
authors.lastname: Weinberg
authors.forename: Charles W
authors.initials: CW
authors.lastname: Bemm
authors.forename: Bruce
authors.initials: B
authors.lastname: Block
mesh_terms: D002662:Child Health Services; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D010349:Patient Compliance; D010414:Pennsylvania / Q000453:epidemiology; D011203:Poverty; D011336:Probability; D018570:Risk Assessment; D014505:Urban Population; D014611:Vaccination / Q000592:standards* / Q000639:trends
chemical_list: D007252:Influenza Vaccines