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Age-Appropriate Compliance of Pertussis Vaccine

Hum Vaccin Immunother; ePub 2018 Jul 19; Krishnarajah, et al

Publish date:

Among children in the US, diphtheria, tetanus, and acellular pertussis (DTaP) vaccination series compliance/completion improved over time, but appear to be suboptimal, potentially increasing pertussis risk. This according to a recent study that examined DTaP completion and compliance rates among commercially insured and Medicaid-enrolled children and aimed to identify predictors of compliance/completion. Children born during 2005-2011 with ≥2 years continuous enrollment from birth provided data for doses 1-4; those with continuous enrollment from birth to age 7 provided dose 5 data. Researchers found:

  • A total of 367,493 commercially insured and 766,153 Medicaid-enrolled children were followed for ≥2 years and 23,574 and 41,284, respectively, for ≥7 years.
  • Series compliance to doses 1-3, 1-4, and 1-5 were 67.2%, 55.3%, 47.5% (commercial) and 37.4%, 27.3%, 14.4% (Medicaid), respectively.
  • Predictors of better compliance/completion included: later birth year and higher household income.
  • Predictors of worse compliance/completion included: Northeast residence, birth hospitalization ≥14 days, and black race/ethnicity.

Citation:

Krishnarajah G, Malangone-Monaco E, Palmer L, Riehle E, Buck PO. Age-appropriate compliance and completion of up to five doses of pertussis vaccine in US children. [Published online ahead of print July 19, 2018]. Hum Vaccin Immunother. doi:10.1080/21645515.2018.1502526.

Commentary:

This study has the most impact on pertussis because of very low rates of diphtheria and tetanus in the US. When children have more well visits scheduled, they are more likely to get the scheduled vaccines. Ultimately, these vaccines will need to be administered to enter school. States that allow a “personal exemption” to childhood vaccines are being found to have lower vaccination rates. Sadly, only California, Mississippi, and West Virginia do not allow these exemptions. Hopefully, tools associated with EMRs can help identify children behind on vaccines. — John Russell, MD

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