Feasibility of influenza immunization for inner-city children aged 6 to 23 months.
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.
Zimmerman
Richard K
RK
Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA. zimmer@pitt.edu
Hoberman
Alejandro
A
Nowalk
Mary Patricia
MP
Lin
Chyongchiou J
CJ
Greenberg
David P
DP
Weinberg
Stuart T
ST
Bemm
Charles W
CW
Block
Bruce
B
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
D007252:Influenza Vaccines