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New observational study suggests use of combination vaccines may improve immunization coverage rates in infants

t vs. 43.5 percent; p<0.001); 3 doses of polio vaccine (71.9 percent vs. 49.6 percent; p<0.001); and 3 doses of hepatitis B vaccine (49.6 percent vs. 22.0 percent; p<0.001). In addition, higher coverage rates were also seen for the combination cohort compared to the component cohort for certain vaccines given in the second year of life: measles, mumps and rubella vaccine (MMR) (86.1 percent vs. 81.4 percent; p<0.001); varicella vaccine (86.1 percent vs. 81.4 percent; p<0.001); and Haemophilus influenzae type b (Hib) (71.7 percent vs. 55.9 percent; p<0.001). Coverage rates were also higher in the combination cohort compared to the component cohort for the 4:3:1:3:3:1 series combination (includes 4 doses of DTaP, 3 doses of polio, 1 dose of MMR, 3 doses of Hib, 3 doses of hepatitis B, and 1 dose of varicella vaccine (34.3 percent vs. 14.9 percent; p<0.001).

Results from this study suggest that incorporation of a combination vaccine into the routine immunization schedule for the first year of life may yield improved coverage rates, said Dr. Marshall. As suggested by improved coverage rates for the varicella and MMR vaccines, the effect might not be limited to the antigens contained in the combination vaccine. Overall, these results suggest that further research is warranted to determine the full impact of combination vaccines on the quality of immunization care.

Two additional observational studies of the Georgia Medicaid population, conducted by Dr. Marshall in collaboration with Applied Health Outcomes, were also presented at NIC today. The first assessed the impact of PEDIARIX on immunization timeliness in the same cohorts to determine if the infants studied received their vaccinations on time, based on the ACIP/AAFP/AAP recommended immunization schedule, or acceptably early as defined by Luman, et al in a previous study sponsored by the Centers for Disease Control and Prevention (CDC)*.

Results from the analysis showed that
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