Many children are undervaccinated or have delayed vaccinations in their first 2 years of life

than 6 months. Vaccine-specific undervaccination of more than 6 months ranged from 9 percent for poliovirus vaccine to 21 percent for Haemophilus influenzae type b vaccine. An estimated 25 percent of children had delays in receipt of 4 or more of the 6 vaccines. Approximately 21 percent of children were severely delayed (undervaccinated for more than 6 months and for 4 or more vaccines).

Factors associated with severe delay included having a mother who was unmarried or who did not have a college degree, living in a household with 2 or more children, being non-Hispanic black, having 2 or more vaccination providers, and using public vaccination provider(s).

"Interventions must be focused on plans that could best address the needs of these mothers, such as extended office hours for women who have difficulty taking time away from work, using appropriate education-level information regarding safety and benefits of vaccination, and ensuring availability of sibling child care in the workplace," the researchers write.

"Assessing days undervaccinated reveals weaknesses in childhood vaccination programs. Physicians are in the best position to assess the needs of their patients to determine reasons for delay. Evidence-based solutions exist for many of these needs, such as reminder-recall systems, extended office hours, expanding availability of pediatric care, and education regarding the importance and safety of vaccinations. Minimizing the time spent incompletely protected from vaccine-preventable diseases is important to the health of individuals and to public health and should be given greater emphasis by public health programs and vaccination providers," the authors write.

"These results confirm that opportunity exists for improvement in vaccine administration in the United States to ensure that all children remain fully vaccinated and optimally protected from vaccine-preventable diseases throughout early childhood--the time when childre

Contact: Curtis Allen
JAMA and Archives Journals

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