The researchers note that while infants could receive as many as five vaccines in one visit, only 3.3 percent of infants do, likely due to the concern that too many shots will overburden the infants immune system. With the recent addition of four doses of pneumococcal vaccine, however, this will will play an increasing important role in childhood vaccination.

MISSED OPPORTUNITIES

Among African-American children, the primary reason for inadequate vaccination coverage does not appear to be too few visits, according to another study using NIS data.

Of the more than one-quarter of black infants who do not receive all their immunization shots, 63.7 percent had had enough visits. As in the previous study, most of the children who failed to receive the full vaccination series also could have completed the series in just one more visit, and 40.3 percent needed only one more shot, says Danni Daniels and CDC colleagues.

Our findings suggest that most of the undervaccination was not a result of limited access to care, but rather a result of missed opportunities. If providers who treated these African-American children had taken advantage of every vaccination contact to evaluate vaccination status and administer all needed doses of vaccines, coverage could have been as high as 90.5 percent, they say.

The majority of children in this study had only one vaccine provider, diminishing the likelihood that gaps in record-keeping were to blame.

African-American infants who were not up-to-date with their vaccinations at age 3 months were more likely to end up severely undervaccinated, prompting the researchers to suggest that providers should evaluate vaccination status at every visit and be alert to children who are
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Contact: National Center for HIV, STD and TB Prevention, CDC
404-639-8895
Center for the Advancement of Health
20-Apr-2001