Impact of practice policies on pediatric immunization rates

Abstract

Objective: To describe the relationship between practice policies and rates of up-to-date (UTD).

Study design: Analysis of data from the 2004-2006 National Immunization Survey (NIS). Practice policies evaluated are immunization provider involvement in a vaccine registry, participation in the Vaccines for Children (VFC) program, and administration of hepatitis B vaccine at birth. The primary outcome is rates of being UTD with the 4:3:1:3:3 vaccination series for children age 19 through 35 months.

Results: The overall rate of UTD is 80.8%; 53.3% of children had providers administer hepatitis B vaccine at birth, which was associated with significantly higher rates of UTD (79.9% vs. 83.1%, P < .01). Children with multiple vaccine providers had lower rates of UTD versus those with only 1 vaccine provider (77.3% vs 82.5%; P < .01). In multivariable analysis, participation in VFC (OR 1.59, 95%, CI 1.16-2.2) and administration of hepatitis B at birth (OR 1.25, 95% CI 1.05-1.5) increased the odds of UTD. Provider participation in a vaccine registry did not significantly impact rates or likelihood of UTD.

Conclusions: Immunization provider policy decisions, including administration of hepatitis B at birth, participation in VFC, and a focus on continuity of care, can improve rates of UTD for children in their practice.