February 28, 2020
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Many children not following ACIP immunization schedule

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Robert A. Bednarczyk

Many young children do not adhere to the early childhood immunization schedule recommended by the CDC’s Advisory Committee on Immunization Practices, study findings showed.

Robert A. Bednarczyk, PhD, an assistant professor of global health and epidemiology at the Emory Vaccine Center, and colleagues analyzed data from the 2014 National Immunization Survey (NIS) and found that 63% of children aged between 19 and 35 months were vaccinated consistent with ACIP’s recommended schedule, 23% followed an alternate pattern and about 14% followed an unknown pattern.

“Seeing really only about two-thirds of kids are fully following that regular schedule, we now have a better indication of the number of young kids that may be susceptible or less susceptible to vaccine preventable diseases in those earlier time points of life,” Bednarczyk said.

The study included vaccinations for hepatitis A and rotavirus, both relatively recent additions to the ACIP schedule that are not typically reported by the CDC, the researchers noted.

“We now have a better understanding of how many children in the United States may be undervaccinated at earlier time points in life even before our normal assessments of whether they are up to date for their childhood vaccine series or not,” Bednarczyk said. “We wanted to look at how many of those kids are not adhering to the schedule in those earlier days.”

According to the study, children who had an alternate vaccination schedule were 4.2 times as likely (95% CI, 3.9-4.5) to not be up to date with their vaccines, whereas children with unknown patterns were about 2.4% as likely (95% CI, 2.2-2.7).

Bednarczyk said the recommended schedule provided by the ACIP is safe and effective and is designed to offer the best level of protection for children when they are most vulnerable to infection.

“I think the take-home message is that a schedule should be followed and that’s going to be the most important thing to keep young children healthy during that period of a more severe disease, should they get sick,” he said.

Bednarczyk said health care providers should work with parents to help them understand the importance of immunizing on time with all vaccine doses. He said children should be vaccinated “completely and on time.”

According to Bednarczyk, the biggest limitation they faced was not understanding why parents may not adhere to the recommended vaccination schedule for their children.

“We have data from the National Immunization Survey for the time points of when children received their vaccines, but we don’t understand this lack of schedule adherence,” he said. “Is it due to vaccine hesitance? Due to other structural barriers that may prohibit keeping up on the schedule? The most we can say from this is that there is a lack of adherence of the regulated schedule, but we can’t say why.” – by Ken Downey Jr.

Disclosures: The authors report no relevant financial disclosures.