RISK-FACTORS FOR DELAYED IMMUNIZATION AMONG CHILDREN IN AN HMO

Objectives. Improving the timely delivery of childhood immunizations h as become a national imperative. This study aimed to identify nonfinan cial predictors of delayed immunization among patients with good finan cial access to preventive care. Methods. This prospective cohort study used telephone interviews and a computerized immunization tracking sy stem to evaluate 13-month-old children (n = 530) in a regional group-m odel health maintenance organization. Results. More than one third of parents interviewed did not know when the next immunization was due. T hirteen percent were late for the measles-mumps-rubella immunization, recommended at 15 months of age, by 90 days or more. Independent predi ctors of delayed immunization included having a larger number of child ren (odds ratio [OR] = 1.4, P < .01), not having a regular doctor (OR = 2.9, P < .05), not knowing when the shot was due (OR = 2.0, P < .01) , and not worrying about the risks of shots (OR = 1.4, P < .05). Concl usions. Financial access alone does not guarantee timely childhood imm unization. In managed carl settings, which may cover increasing number s of children under health care reform, interventions are needed to be tter inform parents of when immunizations are due.