Missed opportunities to immunize preschoolers

Local health departments (n = 122) and private physician offices (n = 90) responded to a mailed survey assessing practices of immunizing children presenting with any of 17 conditions identified in the literature as invalid contraindications to immunizations. More than 30% of both provider groups withheld immunizations in the presence of six conditions identified as invalid, specifically tuberculosis, current antimicrobial therapy, recent exposure to infectious disease, mild diarrheal illness in an otherwise well child, any convalescent phase of an illness, and current or recent mild illness. These findings document provider contributions to the problem of inadequate childhood immunizations and underscore the importance of improved provider education on immunization practices.