UCSD
PARTNERSHIP OF IMMUNIZATION PROVIDERS

BACKGROUND

Immunization is an essential and cost-effective primary prevention activity, and widespread use has had a dramatic effect in the reduction of childhood morbidity and premature mortality. While most children have been properly immunized by the time they enter kindergarten, ensuring that children two years of age or younger are fully immunized to meet the national goal of 90% is more challenging.

National Statistics:
Period ending December 1998:

• 81% of 2 year olds received the recommended series: 4DTP/3OPV/1MMR
  
• 19% (over 1 million 2 year olds) lack one or more doses of this series

During 1989 and 1990, San Diego County experienced a measles epidemic with over 1000 cases and three deaths. As with other areas across the country, half of the San Diego County cases were among preschool-age children. Between 1992 and the present, an ongoing pertussis outbreak has been documented; cases are occurring at 3 to 5 times the rate seen before the outbreak.

The San Diego County Infant Immunization Initiative (I-3) has learned that to raise immunization coverage for infants and toddlers, behaviors of both parents and providers need to be changed. Provider-related behaviors include:

• Assessment of immunization records at every visit.
  
• Communication with parents regarding immunization status of their child.
  
• Consistent immunization record-keeping practices.
  
• Administration of all medically due vaccine doses without delay.
  
• Using an accelerated immunization schedule if a child is more than one month behind on immunizations.

UCSD Partnership of Immunization Providers (PIP) addresses these and other issues within this study.

The Partnership