Delays in receipt of immunizations in low-birth-weight children: a nationally representative sample

Arch Pediatr Adolesc Med. 2001 Feb;155(2):167-72. doi: 10.1001/archpedi.155.2.167.


Background: Studies of very low-birth-weight (VLBW) children discharged from neonatal intensive care units have shown delays in receipt of routine childhood immunizations. However, a recent study of VLBW children in 3 health maintenance organizations found no significant delays in immunizations.

Objective: To assess the risk of immunization delays for moderately low-birth-weight (MLBW; 1500 g-2499 g) and VLBW (<1500 g) children compared with normal-birth-weight children in a nationally representative birth sample.

Design: Logistic regression analysis using the 1988 National Maternal and Infant Health Survey and the 1991 Longitudinal Follow-up Survey.

Setting: Nationally representative sample of children born in 1988 in the United States.

Participants: A total of 8285 children whose mothers completed both surveys.

Main outcome measures: Age at receipt of each of the first 4 doses of diphtheria and tetanus toxoids and pertussis vaccine, the first 3 doses of polio vaccine, and the first dose of measles-mumps-rubella vaccine for MLBW and VLBW children, and normal-birth-weight children. We also examined whether children were up-to-date for all immunizations at ages 12, 24, and 36 months based on birth-weight groups.

Results: Very low-birth-weight children received their first 3 doses of diphtheria and tetanus toxoids and pertussis vaccine and their first 2 doses of polio vaccine significantly later than normal-birth-weight children (P <.001). Very low-birth-weight children were significantly less likely to be up to date for all immunizations at ages 12 months (odds ratio [OR] =.556; P =.001), 24 months (OR =.439; P <.001), and 36 months (OR =.446; P <.001) compared with normal-birth-weight children.

Conclusion: Very low-birth-weight children are at risk for immunization delays compared with normal-birth-weight children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Educational Status
  • Health Care Surveys
  • Health Maintenance Organizations
  • Health Surveys
  • Humans
  • Immunization / statistics & numerical data*
  • Immunization Programs / standards
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Logistic Models
  • Risk Factors
  • Time Factors
  • United States