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Article
April 14, 1993

Standards for Pediatric Immunization Practices

Author Affiliations

the Division of Immunization, Centers for Disease Control and Prevention, Atlanta, Ga.; Association of State and Territorial Directors of Nursing, Jackson, Miss; Centers for Disease Control and Prevention), Atlanta, Ga; Association of Community Health Nursing Educators, New Orleans, La; National Vaccine Injury Compensation Program, Rockville, Md; Milwaukee (Wis) Department of Health; San Antonio (Tex) Metropolitan Health District; National Association of County Health Officials, Cheverly, Md; Health Resources and Services Administration, Rockville, Md; Advisory Committee on Immunization Practices, Durham, NC; American Nurses Association, Seattle, Wash; National Association of Community Health Centers, Washington, DC; Association of State and Territorial Health Officials, Honolulu, Hawaii; University of Washington, Seattle; National Association of Pediatric Nurse Associates and Practitioners, Cherry Hill, NJ; National Association of-Community Health Centers Inc, Washington, DC; American Medical Association, Chicago, Ill; National Migrant Resource Program, Austin, Tex; United States Conference of Local Health Officers, Milwaukee, Wis; Association of Maternal and Child Health Programs, Iowa City, Iowa; Health Resources and Services Administration, Rockville, Md; Health Care Financing Administration, Baltimore, Md; Milwaukee (Wis) Department of Health; American Academy of Pediatrics, Elk Grove Village, Ill; Health Resources and Services Administration, Rockville, Md; Health Resources and Services Administration, Rockville, Md; Conference of State and Territorial Epidemiologists, Jackson, Miss; American Academy of Family Physicians, Columbus, Ohio.

JAMA. 1993;269(14):1817-1822. doi:10.1001/jama.1993.03500140069038
Abstract

THE RESURGENCE of measles in the United States between 1989 and 1991 was associated with 55622 reported cases,1,2 11251 hospitalizations, and over 42 000 hospital days (unpublished data, Centers for Disease Control and Prevention, 1992) and 166 suspected deaths from measles.3 The main cause of the epidemic was failure to vaccinate children at the recommended ages, 12 to 15 months.4

For editorial comment, see p 1844.

While 97% to 98% of children are vaccinated by or shortly after school entry with four doses of diphtheria and tetanus toxoids and pertussis vaccine, three doses of oral poliovirus vaccine, and one dose of measles, mumps, rubella vaccine, series-complete immunization levels among preschool children are considerably lower. Recent surveys of school entrants in nine cities that measured immunization status as of the second birthday documented that only 52% to 71% had been vaccinated against measles.5 Series-complete immunization levels ranged

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