August 1993

US Immunization System Rx: Install New Components

Author Affiliations

Children's Hospital and Medical Center University of Washington 4800 Sand Point Way NE Seattle, WA 98105-0371

Am J Dis Child. 1993;147(8):813-815. doi:10.1001/archpedi.1993.02160320015005

Elsewhere in this issue, Raddish et al1 report their study of the immunization status of children attending the Boston (Mass) Children's Hospital spina bifida clinic. Eighty percent of the children received their first diphtheria and tetanus toxoids and pertussis and oral poliovirus vaccines on time. At 24 months of age, only 58% had received four diphtheria and tetanus toxoids and pertussis, three oral poliovirus, and one measles-mumps-rubella vaccinations. At 7 years of age, 81% had received a total of these eight immunizations. Risk factors for under-immunization included being insured by Medicaid and having a mother with 12 years of school or less. In sum, children at all age levels attending this clinic were less well immunized than the general Massachusetts population and shared common risk factors for underimmunization. The authors note that these dismal results are even more remarkable because the study families had higher incomes than the state's

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