Correlates for Second-dose Varicella Vaccination in School-age Children in a Managed Care Organization in California
The Pediatric Infectious Disease Journal, 06/29/2012
Hechter RC et al. – Efforts targeting non–Hispanic white and black children, parents with a high education level and family medicine physicians might improve uptake of the routine 2–dose varicella vaccination. Incorporation of a requirement for the second–dose varicella vaccine into the school law might help achieve high adherence to the routine 2–dose varicella vaccination in school–age children.Methods
- A total of 67,977 children of 4–6 years (51% male, 50% Hispanic) were included in this retrospective cohort study.
- The second–dose varicella vaccination history was evaluated by using the Kaiser Immunization Tracking System.
- Correlation and multivariable regression analyses were used to test the association between potential correlates and nonadherence to the second–dose varicella vaccination.
- Four–year–old children had a significantly higher vaccination rate (76.1%) than 5–year–olds (43.2%) and 6–year–olds (17.3%) by 12 months after the implementation of routine second–dose varicella vaccination.
- Non–Hispanic white race [rate ratio (RR): 1.13 (95% CI: 1.11–1.15)], living in an area of >75% adults with a high–school diploma [RR: 1.17 (95% CI: 1.14–1.20)], and having a primary care provider specializing in family medicine [RR: 1.15 (95% CI: 1.11–1.18)] significantly correlated with nonadherence.
- Missed opportunity was found in 59.7% (n = 20,465) of children who did not receive the second–dose varicella vaccine in spite of at least 1 outpatient visit and in 15.8% (n = 5407) who received some other vaccines during the follow–up period.