National examination of compliance predictors and the immunization status of children: precursor to a developmental model for health systems

Mil Med. 2004 Oct;169(10):795-803. doi: 10.7205/milmed.169.10.795.


Objectives: The gap between children's immunization requirements and actual compliance is staggering. Using a national survey instrument, the purpose of this study was to analyze the relationship between select predictors and immunization status in children between 19 months and 6 years of age.

Methods: From the 1998 Medical Expenditure Panel Survey, 1575 children were included in a multivariate logistical model. Outcomes were measured as compliance with approved vaccination regimens.

Results: Only 67% of children between 19 months and 6 years old were compliant with all recommended vaccines. However, nonminority children with health insurance from families with income above the federal poverty line or living outside a metropolitan statistical area were more likely to be vaccinated. Children of older or educated parents likewise tended to have complete immunization.

Conclusions: Analyzing childhood immunization via parental characteristics identifies prevalent predictors of compliance. Outcomes suggest potential strategies for health systems to focus on children's health issues--specifically immunizations.

MeSH terms

  • Child, Preschool
  • Humans
  • Immunization / statistics & numerical data*
  • Income
  • Infant
  • Insurance, Health
  • Logistic Models
  • Models, Theoretical
  • Patient Compliance / statistics & numerical data*
  • Socioeconomic Factors