Author/Authors :
Matilde Irigoyen، نويسنده , , Philip LaRussa، نويسنده , , Sally E. Findley، نويسنده , , Shaofu Chen، نويسنده , , Arturo Caesar، نويسنده , , Peter Tesler، نويسنده ,
Abstract :
Impact of the Advisory Committee on Immunization Practicesʹ 4-day grace period in a low-income community Original Research Article
Pages 245-250
Matilde Irigoyen, Philip LaRussa, Sally E. Findley, Shaofu Chen, Arturo Caesar, Peter Tesler
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Abstract
Background
In 2002, the Advisory Committee on Immunization Practices (ACIP) recommended vaccine doses administered ≤4 days before the minimum age or interval be counted as valid. The study objective was to assess the impact of the 4-day grace period on the need for revaccination and associated costs in a low-income community, compared to standard practice (i.e., repeating all doses that fall outside current ACIP guidelines).
Methods
From 1999 to 2001, semi-annual immunization assessments of 8293 randomly selected children, aged 19–35 months, were conducted at a 16-practice network serving an underserved community in New York City. Outcome measures were rates of antigen-specific invalid doses and number of children needing revaccination, with and without the 4-day grace period. Revaccination costs were based on the Vaccines for Children (VFC) price list.
Results
The 4-day grace period reduced the number of children needing revaccination from 17.1% to 12.0%, a drop of 30%. The rates of invalid doses decreased from 1.9% to 1.3%, a drop of 33%. Invalid doses for hepatitis B (HepB)-2 decreased by two thirds (69.7%); for diphtheria–tetanus–acellular pertussis (DTaP)-1, Haemophilus influenzae type b (Hib)-1 and Hib-3 by half (44.9%–50.0%); for Polio-1, Polio-2, Polio-3, and measles–mumps–rubella (MMR) by one third (31.6%–33.3%); and for DTaP-2, DTaP-3, HepB-3, and varicella by nearly one quarter (20.0%–24.0%). At these rates, revaccinating 100,000 children younger than age 3 years would cost $213,588 per year, compared to $152,539 with the 4-day grace period, in vaccine costs alone.
Conclusions
In a low-income community, ACIPʹs 4-day grace period made a significant impact on the number of children requiring revaccination and on revaccination costs. However, the number of children needing revaccination remains high.
Article Outline
• Background
• Methods
• Study setting
• Study sample
• Outcome measures
• Statistical analysis
• Results
• Discussion
• Acknowledgements
• References