Impact of the Change to Inactivated Poliovirus Vaccine on the Immunization Status of Young Children in the United States: A Study From Pediatric Research in Office Settings and the National Medical Association

Abstract

Study children who were >12 months of age at the time that data were collected were categorized as being fully immunized at 12 months if they had received the same vaccines before their first birthday. To assess the effect of type of poliovirus vaccines on these outcomes, study patients were classified as being in an IPV or OPV group based on the initial type of vaccine received. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for IPV as a predictor of being fully immunized at 8 and 12 months of age, after adjusting for race/ethnicity of the patient, maternal education level, year of birth, and method of payment for vaccines. In addition, the effect of clustering of children within practices was accounted for by the use of generalized estimation equation techniques.Results. Data were analyzed on 13 520 children from 177 practices in 42 states; 79.4% of patients were fully immunized at 8 months of age, and 88.7% of those eligible were fully immunized at 12 months of age. A total of 6910 patients (51.1%) were classified as OPV recipients, wheras 5282 (39.1%) received IPV. In addition, 1328 children (9.8%) were documented as having received poliovirus vaccine, but the particular type could not be deter-

Patient Visits to a National Practice-Based Research Network: Comparing Pediatric Research in Office Settings With the National Ambulatory Medical Care Survey

“…Minority representation averaging 15% in the early 1990s 15,16 has risen to proportions in excess of 30% during the past 5 years. 17,18 With respect to Hispanic ethnicity, although the percentage of Hispanic patients in the PROS sample was not significantly different from the NAMCS sample, the difference bordered on significance, suggesting a continuing need to ensure Hispanic representation in PROS studies.…”

Vaccine Policy Changes and Epidemiology of Poliomyelitis in the United States

“…The transition was gradually accepted with no decreases in vaccination coverage or increases in adverse events. [37][38][39][40] Following this change, all forms of poliomyelitis have been eliminated in the United States; the last imported case occurred in 1993 and the last VAPP case in 1999. The only threats from polio in the United States are from laboratories and the few remaining polio-endemic areas in Africa and Asia.…”

Pediatricians' Self-reported Clinical Practices and Adherence to National Immunization Guidelines After the Introduction of Pneumococcal Conjugate Vaccine

“…[3][4][5][6] Studies of previously introduced vaccines have examined parental and pediatrician compliance by determining whether children are up-to-date with their immunizations. [7][8][9][10] However, to our knowledge, no previous studies have attempted to determine whether pediatricians' self-reported practices are themselves adherent to national immunization recommendations.…”