COMPARING A COMPUTER-BASED CHILDHOOD VACCINATION REGISTRY WITH PARENTAL VACCINATION CARDS - A POPULATION-BASED STUDY OF DELAWARE CHILDREN

We conducted a population-based study in Delaware to examine the relia bility of childhood vaccination data in a comprehensive computer-based record system versus parental vaccination cards, We sampled 1,005 chi ldren born between January, 1991, and September, 1993, We oversampled for children whose mothers received Medicaid or were uninsured at the time of delivery, Of the survey responders, 276 (56%) had access to wr itten records, and 409 (83%) records were located in the Delaware immu nization computer database. The kappa coefficient was 0.18. The observ ed agreement was 59.8%, When the two databases were combined, the up-t o-date rate for 2-year-olds was 58.4%, an increase of 12.7% and 24.2% from the computer database and the parental records, respectively, The computer database was 78.1% sensitive and the parental records were 5 4.9% sensitive, These results indicate that a comprehensive computer-b ased record system, with adequate provider participation and proper da ta management, can be more reliable than parental vaccination cards.