FACTORS ASSOCIATED WITH UNNECESSARY IMMUNIZATION GIVEN TO CHILDREN

Objective. To determine the factors associated with unnecessary immuni zation during the preschool years. Methods. Children were selected fro m birth certificates and their parents were interviewed to identify al l immunizations to 72 months of age. The immunizations were verified. Results. Of 187 children studied 34 (18%) received unnecessary immuniz ation. Unnecessary immunization was strongly associated with ever rece iving immunization in a large system of public clinics (designated ''P ublic A'') (33%) compared with other providers (5%) (P < 0.00001). Amo ng children immunized in Public A, unnecessary immunization was associ ated with the parent having an incomplete or no copy of the child's im munization record (P = 0.007) and with not being up to date for immuni zations at 24 months of age (P = 0.04). Complete documentation of immu nizations either in the Public A record or in the parent's copy of the record was associated with a 4% rate of unnecessary immunization; inc omplete or no documentation in both the Public A and the parentis reco rd was associated with a 45% rate of unnecessary immunization (P = 0.0 01). Conclusion. Access to a complete immunization record, be it the p rovider's, the parent's or ideally both, decreases substantially a chi ld's risk of unnecessary immunization.