Vaccinating My Way—Use of Alternative Vaccination Schedules in New York State

Published:October 16, 2014DOI:https://doi.org/10.1016/j.jpeds.2014.09.013

      Objective

      To identify children vaccinated following an alternative vaccine schedule using immunization information system data and determine the impact of alternative schedule use on vaccine coverage.

      Study design

      Children born in New York State, outside New York City, between January 1, 2009 and August 14, 2011 were assessed for vaccination patterns consistent with use of an alternative schedule. Children who by 9 months of age had at least 3 vaccination visits recorded in the statewide mandatory immunization information system after 41 days of age were classified as either attempting to conform to the Centers for Disease Control and Prevention published recommended vaccination schedule or an alternative schedule. The number of vaccination visits and up-to-date status at age 9 months were compared between groups.

      Results

      Of the 222 628 children studied, the proportion of children following an alternative schedule was 25%. These children were significantly less likely to be up-to-date at age 9 months (15%) compared with those conforming to the routine schedule (90%, P < .05). Children following an alternative schedule on average had about 2 extra vaccine visits compared with children following a routine schedule ( P < .05).

      Conclusions

      Almost 1 in 4 children in this study appear to be intentionally deviating from the routine schedule. Intentional deviation leads to poor vaccination coverage leaving children vulnerable to infection and increasing the potential for vaccine-preventable disease outbreaks.
      DTaP ( Diphtheria/tetanus/acellular pertussis), HepB ( Hepatitis B), Hib ( Haemophilus influenzae type b), IPV ( Inactivated poliovirus vaccine), NYC ( New York City), NYS ( New York State), NYSIIS ( New York State Immunization Information System), PCV ( Pneumococcal conjugate vaccine), RV ( Rotavirus vaccine)
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