Nearly Half of Children Under 2 Years of Age Receive Some Vaccinations Late

Kaiser Permanente study examined increasing prevalence of under vaccination


WEBWIRE – Monday, January 21, 2013

DENVER — In a new study published today in JAMA Pediatrics (formerly Archives of Pediatrics and Adolescent Medicine), Kaiser Permanente researchers found that 49 percent of children ages 2-24 months did not receive all recommended vaccinations, or did not get vaccinated according to the Advisory Committee on Immunization Practices schedule.

Kaiser Permanente researchers used the Vaccine Safety Datalink — a collaborative effort among the Centers for Disease Control and Prevention and nine managed care organizations — to analyze immunization records of 323,247 children born between 2004-2008. Data from immunization records helped illuminate the number of days each child was missing scheduled vaccines for any reason, including parents intentionally choosing not to vaccinate their children according to ACIP recommendations. Children who did not receive their vaccines on time were considered “undervaccinated.”

“While a large majority of parents in the U.S. choose to vaccinate their children, a growing number of parents are concerned about vaccine safety and choose to vaccinate their children according to alternative immunization schedules,” said lead study author Jason Glanz, PhD, a senior scientist at Kaiser Permanente’s Institute for Health Research. “The medical community doesn’t have a lot of data on these alternative schedules, so we are hoping the results from this study will open the door to more opportunities to examine their safety and efficacy.”

The study found the number of undervaccinated children increased significantly during the study period, and 1 in 8 undervaccinated children’s parents intentionally chose not to adhere to ACIP immunization guidelines. Alternative schedules either involve increasing the time between vaccinations or reducing the number of vaccinations in a single office visit, leaving children undervaccinated. Study findings also indicate undervaccinated children are less likely to visit their doctor’s offices and more likely to be admitted to hospitals, compared to their peers vaccinated under the standard schedule.

Kaiser Permanente can deliver transformational health research like this study in part because it has the largest private electronic health record system in the world. The organization’s integrated model and electronic health record system securely connect 9 million people, 611 medical offices and 37 hospitals, linking patients with their health care teams, their personal health information, and the latest medical knowledge. The Vaccine Safety Datalink project, which monitors immunization safety and addresses the gaps in scientific knowledge about any rare and serious events that occur following immunization, is enabled in part by Kaiser Permanente’s electronic health record.

Kaiser Permanente is committed to furthering understanding of vaccine effectiveness and safety, including patterns of vaccine refusal. Recent Kaiser Permanente studies found children of parents who refuse vaccines are nine times more likely to get chickenpox and 23 times more likely to get whooping cough than fully immunized children.

Other authors of the paper include: Sophia R. Newcomer, MPH, Komal J. Narwaney, MD, PhD, Simon J. Hambidge, MD, PhD, Matthew F. Daley, MD, Nicole Wagner, MPH, David L. McClure, PhD, and Stan Xu, PhD, of the Kaiser Permanente Colorado Institute for Health Research; Ali Rowhani-Rahbar, MD, PhD, of the Kaiser Permanente Vaccine Study Center; Grace M. Lee, MD, MPH, of the Center for Child Health Care Studies, Department of Population Medicine, Harvard; Jennifer C. Nelson, PhD, of the Group Health Cooperative, Seattle; James G. Donahue, DVM, PhD, of the Marshfield Clinic Research Foundation; Allison L. Naleway, PhD, of Kaiser Permanente Northwest, Portland, Ore.; James D. Nordin, MD, MPH, of HealthPartners Research Foundation, Minneapolis; Marlene M. Lugg, DrPH, of the Kaiser Permanente Southern California Department of Research & Evaluation; and Eric S. Weintraub, MPH, of the Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta.

About the Kaiser Permanente Colorado Institute for Health Research
The Kaiser Permanente Colorado Institute for Health Research (IHR) publishes and disseminates epidemiologic, behavioral, and health services research to improve the health and medical care of Kaiser Permanente members and the communities it serves. The organization has a specific focus on conducting research that can be translated into clinical practice, health promotion, and policies to influence the health of individuals and populations. Currently, the IHR’s staff of more than 120 is working on more than 160 epidemiological, clinical, behavioral, community, and health services research projects. Now in its 20th year of operation, the IHR is responsible for many landmark findings. Among the most notable are recent studies about vaccine safety and refusal, and home blood-pressure monitoring and research that identified life-saving practices for heart attack patients in the emergency room. Teams of investigators collaborate on major research projects with national partners including the Centers for Disease Control and Prevention Vaccine Safety Datalink, the HMO Research Network, and the NIH Cardiovascular Research Network and the Cancer Research Network. Learn more at http://kpco-ihr.org.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.



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