title: Vaccinating my way--use of alternative vaccination schedules in New York State.
abstract: OBJECTIVE
  To identify children vaccinated following an alternative vaccine schedule using immunization information system data and determine the impact of alternative schedule use on vaccine coverage.
  
  
  METHODS
  Children born in New York State, outside New York City, between January 1, 2009 and August 14, 2011 were assessed for vaccination patterns consistent with use of an alternative schedule. Children who by 9 months of age had at least 3 vaccination visits recorded in the statewide mandatory immunization information system after 41 days of age were classified as either attempting to conform to the Centers for Disease Control and Prevention published recommended vaccination schedule or an alternative schedule. The number of vaccination visits and up-to-date status at age 9 months were compared between groups.
  
  
  RESULTS
  Of the 222 628 children studied, the proportion of children following an alternative schedule was 25%. These children were significantly less likely to be up-to-date at age 9 months (15%) compared with those conforming to the routine schedule (90%, P < .05). Children following an alternative schedule on average had about 2 extra vaccine visits compared with children following a routine schedule (P < .05).
  
  
  CONCLUSIONS
  Almost 1 in 4 children in this study appear to be intentionally deviating from the routine schedule. Intentional deviation leads to poor vaccination coverage leaving children vulnerable to infection and increasing the potential for vaccine-preventable disease outbreaks.
authors.affiliation: School of Public Health, State University of New York, University at Albany, Rensselaer, NY.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Nadeau
authors.affiliation: School of Public Health, State University of New York, University at Albany, Rensselaer, NY; Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bednarczyk
authors.affiliation: New York State Department of Health, Albany, NY.
authors.forename: Munyaradzi R
authors.initials: MR
authors.lastname: Masawi
authors.affiliation: New York State Department of Health, Albany, NY.
authors.forename: Megan D
authors.initials: MD
authors.lastname: Meldrum
authors.affiliation: New York State Department of Health, Albany, NY.
authors.forename: Loretta
authors.initials: L
authors.lastname: Santilli
authors.affiliation: New York State Department of Health, Albany, NY.
authors.forename: Shelley M
authors.initials: SM
authors.lastname: Zansky
authors.affiliation: New York State Department of Health, Albany, NY.
authors.forename: Debra S
authors.initials: DS
authors.lastname: Blog
authors.affiliation: School of Public Health, State University of New York, University at Albany, Rensselaer, NY; New York State Department of Health, Albany, NY.
authors.forename: Guthrie S
authors.initials: GS
authors.lastname: Birkhead
authors.affiliation: Institute for Health and the Environment, State University of New York, University at Albany, Rensselaer, NY. Electronic address: LAMCNUTT@gmail.com.
authors.forename: Louise-Anne
authors.initials: LA
authors.lastname: McNutt
mesh_terms: D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D009518:New York; D010342:Patient Acceptance of Health Care; D012449:Safety; D016312:Treatment Refusal; D014611:Vaccination / Q000706:statistics & numerical data*