title: Promoting measles vaccination in attendees not yet immunized at day-care centers in Kyoto City.
abstract: BACKGROUND
  Due to the low measles vaccination rate, localized measles epidemics occasionally occur in Japan with the majority of sufferers being children under 2 years of age. Despite an increased risk of infection at day-care centers, the measles vaccination coverage for day-care attendees is lower than children who are reared-at-home or attend kindergartens. This study aims to describe the current state of measles prevention policy at day-care centers and to examine factors associated with vaccine promotion.
  
  
  METHODS
  A cross-sectional study using anonymous self-administered questionnaires were distributed to the director or person-in-charge at 250 all licensed day-care centers in Kyoto City, Japan, in 2004. The preventive measures against measles at day-care centers and factors related to carrying out the promotion of measles vaccination were examined. Descriptive statistics and odds ratios (OR) using a logistical model were presented.
  
  
  RESULTS
  Out of 250 day-care centers, 187 questionnaires were returned (response rate, 74.8%). Measles vaccination history was taken at 161 day-care centers (86.1%) at the time of enrollment; only 61 day-care centers (32.6%) took a history during the school year. A total of 101 day-care centers (54.0%) promoted measles vaccination in day-care attendees who had not yet been immunized. Day-care centers which promoted it were more likely to be 'public facility' (OR, 3.09) and 'having opportunities to learn about vaccination' (OR, 5.55). After adjustment, 'having opportunities to learn about vaccination' and 'having knowledge that measles vaccination is best under the age of 15 months' were significantly related to carrying out the promotion of measles vaccination (OR, 6.47; 95% confidence interval, 2.52-18.61; OR, 3.12; 95% confidence interval, 1.45-6.95, respectively).
  
  
  CONCLUSIONS
  Preventive measures for measles at day-care centers are currently insufficient. Increasing opportunities to learn about vaccination may encourage promotional behavior.
authors.affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Takayo
authors.initials: T
authors.lastname: Matsumura
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.forename: Naoko
authors.initials: N
authors.lastname: Hamagashira
mesh_terms: D000328:Adult; D000368:Aged; D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage*; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013663:Teaching
chemical_list: D008458:Measles Vaccine