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November 10, 1993

Measles Vaccination in Pediatric Emergency Departments During a Measles Outbreak

Author Affiliations

From the Division of Immunization, National Center for Prevention Services, Centers for Disease Control and Prevention, Atlanta, Ga. Dr Lindegren is now with the Division of HIV/AIDS, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga. Dr Farizo is now with the Center for Biologics Evaluation and Research, Food and Drug Administration, Bethesda, Md.

JAMA. 1993;270(18):2185-2189. doi:10.1001/jama.1993.03510180055033

Objective.  —To determine the proportion of preschool-aged patients attending two inner-city hospital pediatric emergency departments (EDs) who were eligible for measles vaccination, to describe their demographic and clinical characteristics, and to assess the performance of the ED immunization programs that were implemented during a measles outbreak in vaccinating eligible children.

Design.  —Cross-sectional study.

Setting.  —Pediatric EDs of two urban hospitals in Chicago, Ill., in 1989.

Participants.  —Children 6 months to 5 years of age seen in the EDs.

Intervention.  —None.

Main Outcome Measures.  —The proportion of preschool-aged patients attending the two EDs who were eligible for measles vaccination and the proportion of vaccine-eligible children who were given measles vaccine.

Results.  —Of 508 ED patients at hospital A and 255 patients at hospital B, 18% and 29%, respectively, were considered to be vaccine eligible. The most common discharge diagnoses of eligible patients were viral syndrome, otitis media, and minor trauma. Of vaccine-eligible patients, 59% at hospitals A and B were not vaccinated in the ED. At hospital B, patients with an infectious or respiratory disease diagnosis were less likely to be vaccinated than those with other diagnoses (P<.05).

Conclusions.  —Many children seen in these EDs were eligible for measles vaccination, and many eligible patients were not vaccinated. During community outbreaks of measles, optimal vaccination programs in pediatric EDs could increase vaccination coverage among inner-city preschool-aged children who may have limited access to health care.(JAMA. 1993;270:2185-2189)