MEASLES VACCINATION IN PEDIATRIC EMERGENCY DEPARTMENTS DURING A MEASLES OUTBREAK

Objective.-To determine the proportion of preschool-aged patients atte nding two inner-city hospital pediatric emergency departments (EDs) wh o were eligible for measles vaccination, to describe their demographic and clinical characteristics, and to assess the performance of the ED immunization programs that were implemented during a measles outbreak in vaccinating eligible children. Design.-Cross-sectional study. Sett ing.-Pediatric EDs of two urban hospitals in Chicago, Ill, in 1989. Pa rticipants.-Children 6 months to 5 years of age seen in the EDs. Inter vention.-None. Main Outcome Measures.-The proportion of preschool-aged patients attending the two EDs who were eligible for measles vaccinat ion and the proportion of vaccine-eligible children who were given mea sles vaccine. Results.-508 ED patients at hospital A and 255 patients at hospital B, 18% and 29%, respectively, were considered to be vaccin e eligible. The most common discharge diagnoses of eligible patients w ere viral syndrome, otitis media, and minor trauma. Of vaccine-eligibl e patients, 59% at hospitals A and B were not vaccinated in the ED. At hospital B, patients with an infectious or respiratory disease diagno sis were less likely to be vaccinated than those with other diagnoses (P<.05). Conclusions.-Many children seen in these EDs were eligible fo r measles vaccination, and many eligible patients were not vaccinated. During community outbreaks of measles, optimal vaccination programs i n pediatric EDs could increase vaccination coverage among inner-city p reschool-aged children who may have limited access to health care.