| Show Childhood Immunizations Applying Small Area Assessment to Salt Lake County Jeanette Roberts Ph Robin Jacobs B S Abstract Childhood immunization rates at 24 months of age were analyzed asfunction of zip code in Salt Lake County This small area assessment was applied in order to determine if pockets of underimmunization are present that are masked by reporting data by larger geographic areas Data from public providers showed five zip codes with immunization rates less that 85 84101 84102 84111 84116 and 84124 Comparable data from private providers were not available There were no discemable patterns across these zip codes or in comparison tozip code with high immunization rates with respect to variables such as per capita income or local availability of medical care Assumptions that more affluent communities require no assistance with increasing or maintaining immunization rates was not supported Small area assessment isvaluable tool to identify health-related concerns at the local level to allow more meaningful planning and allocation of scarce resources Introduction and Background Surveillance of vaccine-preventable diseases particularly in children playsvery important role in public health The prevention of infectious diseases by vaccines throughout the 20th century contributed substantially to the increase in lifespan observed during that period National Immunization Program 1999 While success has been dramatic the microorganisms that cause many common diseases still exist necessitating continued vigilance The improvements in health status are largely due to immunization during the first two years of lfe referred to herein as childhood immunizations While immunizations early in ife are known to be very effective it iscomplicated and confusing process According 1o the current Centers for Disease Control and Prevention CDC recommendations 2-yearold child is considered totally immunized ifhe has receivedseries of shots known as33 that is diphtheria tetanus pertussis DTaP polio IPV measles mumps rubella MMR Hemophilis influenza type HiB andhepatisinoculations Recommended Childhood Immunization Schedule 2000 The term adequately immunized usually refers to the completion of the3set of immunizations Data are usually reported as the percentage of children up-todate UTD The national goal for childhood immunization was set at 90 totally immunized in Healthy People 2000 2000 This milestone has been maintained in the Healthy People 2010 2000 document The costs associated with vaccine-preventable diseases are substantial An estimated 25 is saved in direct and indirect medical costs for each spent Immunization Fact Sheet 2000 However vaccinations are not without negative aspects and risks Nemeneck 2000 Numerous issues have arisen over the years such as the presence of mercury-containing Thimerosal in vaccinations and the well-publicized recall of the new rotavirus vaccine due to the development of an unexpected bowel disorder Immunization Issues 2000 More serious issues have been raised as well such as the potential induction of autism and Chrohndisease by the MMR vaccine Anonymous 2000 Griffin 2000 These associations remain questionable Patja et al 2000 Recent vaccine-associated paralytic polio apparently caused by the reacquisition of virulence by the oral vaccine form has also been reported Greensfelder 2000 The possibility of these and other serious negative outcomes representsmajor barrier to immunization there are numerous others In Utah the nature of our families large with several closely-spaced children is thought to also contribute substantially to low immunization rates Childhood Immunization 2000 Utah has classically been last on the national list of immunization rates This contributes to the likelihood of outbreaks of vaccine-preventable disease For example 297 cases of pertussis were reported in Utah in 1998 117 of those were confirmed Utah Reported Cases 2000 In April 2000 measles case was confirmed in Park City Utah State Listserve 2000 These examples illustrate the continued need for childhood immunizations and the programs that drive them Digital image 2005 Marriott Library University of Utah Al rights reserved |
