title: The Challenges in Measuring Local Immunization Coverage: A Statewide Case Study.
abstract: There are many forms of existing immunization surveillance in the United States and Washington state, but all are limited in their ability to provide timely identification of clusters of unimmunized individuals and assess the risk of vaccine-preventable diseases. This article aims to: (1) describe challenges to measuring immunization coverage at a local level in the United States using Washington State as a case study; and (2) propose improvements to existing surveillance systems that address the challenges identified.
authors.affiliation: Departments of Pediatrics, and Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia; elizabeth.wolf@vcuhealth.org.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Wolf
authors.affiliation: Epidemiology, University of Washington, Seattle, Washington;
authors.forename: Ali
authors.initials: A
authors.lastname: Rowhani-Rahbar
authors.affiliation: Epidemiology, University of Washington, Seattle, Washington; King County Department of Public Health, Seattle, Washington; and.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Duchin
authors.affiliation: Washington State Department of Health, Olympia, Washington.
authors.forename: M Patricia
authors.initials: MP
authors.lastname: DeHart
authors.affiliation: Departments of Pediatrics, and Seattle Children's Research Institute, Seattle, Washington;
authors.forename: Douglas
authors.initials: D
authors.lastname: Opel
mesh_terms: D016208:Databases, Factual; D058872:Epidemics / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D032541:Mass Vaccination / Q000706:statistics & numerical data*; D010290:Parents; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D012307:Risk Factors; D012574:Schools; D014861:Washington