The Effect of Epidemic Measles on Immunization Rates

Karen P. Goldstein

32 citations0/0 files storedJAMA

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Vaccine Coverage and Hesitancy Virology and Viral Diseases Immune responses and vaccinations

Abstract

OBJECTIVE: To evaluate whether immunization against a vaccine-preventable disease is sought to avoid the naturally occurring disease itself, we hypothesized that the rate of "on-time" measles immunization would increase during an epidemic of that disease. If such an effect occurred, we wondered whether it would have an impact on on-time administration of other recommended immunizations. DESIGN: Retrospective evaluation of immunization rates of children at their second birthday with the use of computerized health records of children entering kindergarten in an 8-year interval spanning the onset of epidemic measles in Chicago, Ill, in 1989 and 1990. SETTING: Children entering Chicago public schools. MAIN OUTCOME MEASURES: Rates of receipt of measles-containing vaccine (MCV), 1 to 4 doses of a diptheria toxoid-tetanus toxoid-pertussis (DTP) or diphtheria toxoid-tetanus toxoid (DT) vaccine, 1 to 3 doses of oral or inactivated polio vaccine (OPV/IPV), and the full series of these vaccines (4:3:1) that are required to be "up-to-date" by the second birthday. RESULTS: The rate of on-time MCV receipt increased from 56% to 58% in the years prior to 70% during the epidemic (1989 and 1990). A similar increase did not occur to DTP/DT 4 or OPV/IPV 3. Moreover, among older children delayed in MCV receipt, evidence of catch-up immunization also occurred during the epidemic years; similar catch-up for delayed DTP/DT 4 or OPV/IPV 3 immunization did not occur. CONCLUSIONS: Dramatic increases in one-time and catch-up MCV receipt occurred during the Chicago measles epidemic of 1989 and 1990. The lack of similar increases in DTP/DT 4 and OPV/IPV 3 suggests MCV receipt was not associated with receipt of other recommended immunizations during that time.

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References

1991The Measles Epidemic 1993Risk Factors for Delayed Immunization in a Random Sample of 1163 Children From Oregon and Washington 1993Missed Opportunities for Childhood Vaccinations in Office Practices and the Effect on Vaccination Status 1995Factors Related to Immunization Status Among Inner-City Latino and African-American Preschoolers 1994Risk Factors for Underimmunization in Poor Urban Infants 1990Barriers to Vaccinating Preschool Children 1994Immunization Practices of Pediatricians and Family Physicians in the United States 1994Low vaccination levels of US preschool and school-age children. Retrospective assessments of vaccination coverage, 1991-1992

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