Despite need for more shots, immunization

November 08, 2001

Recent changes in routine infant vaccination procedures that require a greater number of shots do not appear to reduce immunization rates in low-income communities, a new study reports.

This finding should help reassure policy-makers and immunization providers who "were concerned that the multiple simultaneous injections could decrease immunization coverage levels" against polio, diphtheria, tetanus, whooping cough, Hemophelia influenza type b and hepatitis B, according to lead author Maureen Kolasa, RN, MPH of the Centers for Disease Control and Prevention.

The additional injections reduce the risk of adverse reactions - most notably vaccine-associated paralytic polio - but increase the number of required injections at an infant's 2- and 4-month immunization visits to as many as four.

To assess the impact of the new recommendations, the authors followed infants at publicly funded health clinics serving racially diverse clients primarily with low socio-economic status in Philadelphia, Jacksonville and Milwaukee. Immunization rates were assessed at each clinic for one group of infants who got the previously preferred regimen of shots and for three successive groups getting a sequence of shots. Initial enrollment for each group ranged from 371 to 524, with 8 percent to 16 percent of each group lost to follow-up during the study period.

Results of the study appear in the November issue of The American Journal of Preventive Medicine.

In each city, infants received significantly fewer injections at their 2- and 4-month visits on the older regimen (one or two a visit) than on the multiple-shot regimen (three or four a visit). Nevertheless, the percentage of infants remaining up-to-date in their vaccinations not only failed to decrease on the newer, more injection-intensive regimen, but actually increased slightly.

These findings, the authors note, demonstrate "the feasibility of implementing immunization schedules requiring up to four injections at one visit," despite previously-documented parental and physician concerns that such schedules might not be acceptable.

Kolasa and her colleagues credit parental acceptance of the new regimen to care providers' and clinic administrations' ready acceptance of the switch to an injectable form of polio vaccine as well as to the use of the DtaP series of shots - safer versions of vaccines already in use.

The authors are careful to note that their findings do not guarantee that a schedule with different vaccines or one requiring more than four injections would be as acceptable.
The study was conducted under the auspices of the Centers for Disease Control and Prevention.

The American Journal of Preventive Medicine, sponsored by the Association of Teachers of Preventive Medicine and the American College of Preventive Medicine, is published eight times a year by Elsevier Science. The Journal is a forum for the communication of information, knowledge and wisdom in prevention science, education, practice and policy. For more information about the Journal, contact the editorial office at (619) 594-7344.

Posted by the Center for the Advancement of Health For more research news and information, go to our special section devoted to health and behavior in the "Peer-Reviewed Journals" area of Eurekalert!, For information about the Center, call Ira Allen, (202) 387-2829.

Center for Advancing Health

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