DO PROVIDER PRACTICES CONFORM TO THE NEW PEDIATRIC IMMUNIZATION STANDARDS

Objective: Standards for pediatric immunization practices were issued by the Centers for Disease Control and Prevention, Atlanta, Ga, in May 1992. This article provides baseline data on immunization practices r elated to eight of the standards. Design: Survey of pediatric provider s before publication of the standards. Setting: Baltimore, Md. Partici pants: Forty of the 41 health centers, clinics, and private practices serving children in designated highrisk census tracts participated in the survey. One hundred seventy-three of the 251 eligible physicians a nd nurse practitioners at the sites responded. Main Outcome Measures: Conformity with the eight standards was measured as a percentage of ei ther sites or physicians and nurse practitioners across the sites. Res ults: Conformity with the standards varied, ranging from nearly univer sal conformity with the need to educate parents and guardians about im munizations (standard 5) to less than 3% for simultaneous administrati on of all vaccine doses when a child is first eligible (standard 8). F or most of the standards, considerable variability was found between a nd within public and private sites. Conclusions: Providers often follo wed practices that did not conform to the new standards (prior to issu ance). Some of the standards are ambiguous and require clarification b efore they can be fully applied. The impact of the standards on immuni zation rates and pediatric primary health care has yet to be tested em pirically.