PRESCHOOL-CHILDREN AT HIGH-RISK FOR MEASLES - OPPORTUNITIES TO VACCINATE

Objectives. In 1989 and 1990 the United States experienced a measles e pidemic with more than 18 000 and 27 000 reported cases, respectively. Nearly half of all persons with measles were unvaccinated preschool c hildren under 5 years of age. We sought to identify potential sites fo r vaccine delivery. Methods. Preschool children with measles were surv eyed in five inner cities with measles outbreaks in 1989 to 1990 to as sess the children's use of health care services and federal assistance programs before contracting measles. Results. Of 972 cases children s urveyed, 618(64%) were eligible for measles vaccination at measles on- set. Of those, 93% had previously visited a health care provider (priv ate physician, public clinic, hospital emergency department, or hospit al outpatient department) and 65% were enrolled in a federal assistanc e program (AFDC, WIC, or food stamps). Based on parent-reported reason s for health care visits, in Dallas and New York City, health care pro viders of 24% of 172 children may have missed at least one opportunity to administer measles vaccine. Conclusions. Many potential opportunit ies exist to raise the vaccination coverage of unvaccinated preschool children. These opportunities depend on (1) health care providers taki ng advantage of all opportunities to vaccinate, and (2) immunization s ervices being linked to federal assistance programs.