Vaccines for Children program, United States, 1997

Objectives. 1) To determine the proportion of preschool children receiving immunizations from providers enrolled in the Vaccines for Children (VFC) pr ogram; 2) to assess whether their immunization providers serve as their med ical home for primary care; and 3) to examine the relationship between vari ous provider characteristics and immunization status. Design. Two-phase national survey consisting of parent interviews verified by provider record check. Setting. A total of 78 survey areas (50 states, the District of Columbia, a nd 27 urban areas). Patients or Other Participants. Noninstitutionalized children from 19 to 35 months of age in 1997. Interventions. None. Outcome Measures. VFC penetration rate (the percentage of children who rece ived all or some vaccines from a VFC-enrolled provider); the frequency with which children received all or some vaccines within a medical home; the nu mber of parent-reported immunization providers; and 4:3:1:3 up-to-date stat us at 19 to 35 months of age. Results. Of 28 298 children interviewed for whom consent to contact provide rs was obtained, complete provider data were available for 21 522 (76%). Of these children, 75% received all or some immunizations from a VFC-enrolled provider, 73% received all or some immunizations within a medical home, an d 75% had one immunization provider. Children received all or some immuniza tions from a VFC-enrolled provider more frequently when vaccinated by pedia tricians versus family physicians or in public facilities versus private pr actice. After controlling for poverty, immunization coverage varied only sl ightly with receipt of vaccines from a VFC-enrolled provider, receipt of va ccines within a medical home, and the number of parent-reported providers. Among children vaccinated within a medical home, those vaccinated solely by pediatricians were 1.63 times as likely to be 4:3:1:3 up-to-date than were those vaccinated solely by family physicians after removing the effects of poverty. Recommendations. Greater numbers of children are likely to benefit from an even higher participation rate among immunization providers in the VFC prog ram, particularly among family physicians and private physicians. The publi c-private collaboration developed by the VFC program should be capitalized on so that public sector resources can help pediatricians and family physic ians practice according to the Standams for Pediatric Immunization Practice s.