Interaction of socioeconomic status and provider practices as predictors of immunization coverage in Virginia children

摘要: Objective. To describe the pattern of immunization in cohort children who entered public schools Virginia 1992. Design. This was a historic study using stratified cluster sampling. Three strata were created based on socioeconomic status (SES) catchment area each school Virginia. Setting. The random sample included elementary throughout Participants. Immunization records obtained for randomly selected 2519 first-grade Outcome Measures. Age at completion recommended childhood vaccines determined from birth to entry by SES, race, and population density. Provider practices assessed ascertaining missed opportunities simultaneous administration vaccinations according schedules. Results. Although rates high entry, low levels coverage found all areas 24 months age regardless SES (as measured per capita income), density, or race. However, under-immunization more severe poor urban (42.3% low-SES age-appropriately immunized versus 64.0% high-SES rural areas). By multivariate logistic regression, race gender not predictors which appropriately 2 years after adjusting following : receiving first DTP (diphtheria, tetanus, pertussis) OPV (oral polio) vaccination 3 age, failure have administered simultaneously with second OPV. Receiving strongest being age. effect vaccinate predicting strongly modified SES. Children attended located census tracts incomes less than $10 600 did doses 33.19 times likely be compared greater $18 800 received (95% confidence interval: 18.29 60.22). Conclusions. beginning schedule crucial appropriate later life, provider important under-immunization. Failure administer influenced poorer Serious delays vaccine observed only areas, but also before entry. Pediatrics 1995 ;96 :439-446 ; coverage, social class, practices, sampling, regression.