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Abstract:
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Simultaneous administration of all age-appropriate doses of vaccines is an effective strategy for increasing vaccination coverage. Coverage for the fourth dose of DTaP (diphtheria, tetanus toxoids and acellular pertussis) among children 19-35 months has not reached the Healthy People 2020 target 90%. Risk factors for missed opportunities for simultaneous administration of the fourth dose of DTaP have not been fully investigated. A missed opportunity is defined as failure to administer an age eligible fourth dose of DTaP during the same provider visit. This study used 2001-2014 National Immunization Survey data to evaluate the risk factor for missed opportunities. The results indicated that 7.4% (7.2%, 7.6%) of children missed the opportunity in the U.S.; across all 13 risk factors considered the missed opportunities ranged from 3.3% to 22.9%; the Timeliness of the 1st through the 3rd dose of DTaP were the significant and modifiable risk factors both in binary and multivariate analyses, the adjusted risk ratios for late vs. on-time are 1.6, 1.7, and 3.2. Strategies to reduce missed opportunities should pay special attention to the timeliness of the first 3 doses of DTaP vaccination.
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