Delays in receipt of immunizations in low-birth-weight children: a nationally representative sample.

Diane L. Langkamp · Stacy Hoshaw‐Woodard · Mark E. Boye · Stanley A. Lemeshow

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Vaccine Coverage and Hesitancy Infant Development and Preterm Care Maternal and Neonatal Healthcare

Abstract

BACKGROUND: Studies of very low-birth-weight (VLBW) children discharged from neonatal intensive care units have shown delays in receipt of routine childhood immunizations. However, a recent study of VLBW children in 3 health maintenance organizations found no significant delays in immunizations. OBJECTIVE: To assess the risk of immunization delays for moderately low-birth-weight (MLBW; 1500 g-2499 g) and VLBW (<1500 g) children compared with normal-birth-weight children in a nationally representative birth sample. DESIGN: Logistic regression analysis using the 1988 National Maternal and Infant Health Survey and the 1991 Longitudinal Follow-up Survey. SETTING: Nationally representative sample of children born in 1988 in the United States. PARTICIPANTS: A total of 8285 children whose mothers completed both surveys. MAIN OUTCOME MEASURES: Age at receipt of each of the first 4 doses of diphtheria and tetanus toxoids and pertussis vaccine, the first 3 doses of polio vaccine, and the first dose of measles-mumps-rubella vaccine for MLBW and VLBW children, and normal-birth-weight children. We also examined whether children were up-to-date for all immunizations at ages 12, 24, and 36 months based on birth-weight groups. RESULTS: Very low-birth-weight children received their first 3 doses of diphtheria and tetanus toxoids and pertussis vaccine and their first 2 doses of polio vaccine significantly later than normal-birth-weight children (P <.001). Very low-birth-weight children were significantly less likely to be up to date for all immunizations at ages 12 months (odds ratio [OR] =.556; P =.001), 24 months (OR =.439; P <.001), and 36 months (OR =.446; P <.001) compared with normal-birth-weight children. CONCLUSION: Very low-birth-weight children are at risk for immunization delays compared with normal-birth-weight children.

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References

1993Risk Factors for Delayed Immunization in a Random Sample of 1163 Children From Oregon and Washington 1995Factors Related to Immunization Status Among Inner-City Latino and African-American Preschoolers 1994Risk Factors for Underimmunization in Poor Urban Infants 1993Accuracy of Immunization Histories Provided by Adults Accompanying Preschool Children to a Pediatric Emergency Department 1999Strategies to Sustain Success in Childhood Immunizations

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2012Præventis, the immunisation register of the Netherlands: a tool to evaluate the National Immunisation Programme 2009Evaluation of Vaccine Coverage for Low Birth Weight Infants During the First Year of Life in a Large Managed Care Population 2019Early Childhood Vaccination Status of Preterm Infants 2004Predictors of incomplete immunisation in Victorian children 2012Low Rates of Influenza Immunization in Young Children Under Ontario’s Universal Influenza Immunization Program 2013Delayed Start of Diphtheria, Tetanus, Acellular Pertussis and Inactivated Polio Vaccination in Preterm and Low Birth Weight Infants in the Netherlands 2014Vaccine schedule compliance among very low birth weight infants in Lima, Peru

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