Delays in receipt of immunizations in low-birth-weight children - A nationally representative sample

Background: Studies of very low-birth-weight (VLBW) children discharged fro m neonatal intensive care units have shown delays in receipt of routine chi ldhood immunizations. However, a recent study of VLBW children in 3 health maintenance organizations found no significant delays in immunizations. Objective: To assess the risk of immunization delays for moderately low-bir th-weight (MLBW; 1500 g-2499 g) and VLBW (<1500 g) children compared with n ormal-birth- weight children in a nationally representative birth sample. Design: Logistic regression analysis using the 1988 National Maternal and I nfant Health Survey and the 1991 Longitudinal Follow-up Survey. Setting: Nationally representative sample of children born in 1988 in the U nited States. Participants: A total of 8285 children whose mothers completed both surveys . Main Outcome Measures: Age at receipt of each of the first 4 doses of dipht heria and tetanus toxoids and pertussis vaccine, the first 3 doses of polio vaccine, and the first dose of measles-mumps-rubella vaccine for MLBW and VLBW children, and normal-birth-weight children. We also examined whether c hildren were up-to-date for all immunizations at ages 12, 24, and 36 months based on birth-weight groups. Results: Very low-birth-weight children received their first 3 doses of dip htheria and tetanus toxoids and pertussis vaccine and their first 2 doses o f polio vaccine significantly later than normal-birth-weight children (P<.0 01). Very low-birth-weight children were significantly less likely to be up to dale for all immunizations at ages 12 months (odds ratio [OR]=.556; P=. 001), 24 months (OR=.439; P<.001), and 36 months (OR=.446; P<.001) compared with normal-birth-weight children. Conclusion: Very low-birth-weight children are at risk for immunization del ays compared with normal-birth-weight children.