Title: Hepatitis B and MMR Vaccine Coverage Levels Among Children Entering 7th Grade in Los Angeles County
1Hepatitis B and MMR Vaccine Coverage Levels Among
Children Entering 7th Grade in Los Angeles County
- Wang, Rose, MPH Gambill, David, MS Pulido,
Marifi, MPH Todoroff, Cheri, MPH Fujimoto,
Glen Hartoonian, Lidoosh Roby, Karen - Los Angeles County Department of Health Services
- Immunization Program
2Background
- On July 1, 1999 California implemented a new
school entry immunization requirement - Prior to entering 7th grade students must
receive - 3 doses of hepatitis B vaccine (HBV)
- 2 doses of measles containing vaccine (MCV)
- New and unfamiliar concept to many parents,
schools, and providers
3Background
- California Department of Health Services
conducted Fall 1999 Seventh Grade Immunization
Assessment to evaluate immunization rates during
the 1st year of this new law - Complete defined as
- 3 doses of HBV
- 2 doses of measles containing vaccine (MCV)
- Conditional entrants not reported
4Sample Assessment Form
IMMUNIZATION ASSESSMENT OF SEVENTH GRADE STUDENTS
481
7TH GRADE ENROLLMENT
57th Grade Immunization Assessment Results, Fall
1999
PME is Permanent Medical Exemption and PBE
is Personal Beliefs Exemption
6Objective
- To determine completion rates by ethnicity for
both HBV and MCV of 7th grade students at three
points in time - Age at 7th grade entry
- Age 11
- Age 10
7Methods
- 40 of 851 reporting schools were randomly
selected for retrospective review - Review was conducted May-June 2000
- Schools with less than 20 enrolled 7th grade
students were not included in the sample
selection - Both public and private schools were included in
the sample
8Methods
- 33 of 40 schools had self-reported completion
rates lt 60 - 7 of 40 schools had self-reported completion
rates ? 60 - CASA software used as data collection and
sampling tool - If lt 200 7th grade students, then all active
records were reviewed - If ? 200 students, then a maximum of 200 randomly
selected records were reviewed
9Methods
- Total number of 7th grade records reviewed (n
5,103) - For each record selected we collected
- Date of birth
- Race/ethnicity
- Dates when each dose of HBV and MCV was
administered - Analyzed completion rates by race/ethnicity at
7th grade entry, age 11, and age 10
10ResultsRace/Ethnicity of Studentsn 5,103
11ResultsCompletion Rates at Specific Age Intervals
12Coverage Levels for 3 Doses of Hepatitis B
Vaccine (HBV)by Race and Age
13Coverage Levels for 1 Dose of Measles Containing
Vaccine (MCV)by Race and Age
14Coverage Levels for 2 Doses of Measles Containing
Vaccine (MCV)by Race and Age
15Discussion
- Immunizations for pre-adolescents was an
unfamiliar concept prior to implementation of the
law - Completion rates were generally higher for MCV
than for HBV - Our retrospective review estimated higher
completion rates at 7th grade entry than those
reported by schools
16Discussion
- Schools self-reported completion rates may
underestimate true completion rates among 7th
grade students due to - Lack of familiarity with reviewing immunization
records - Miscalculations when completing the form
- Incomplete student immunization records at time
of assessment
17Discussion
- Data limitations
- Selection bias of schools
- Selection bias of records
- Timeliness of review
- Changes in student population
- Immunization awareness programs/activities
conducted by other agencies, clinics or schools
18Conclusion
- Implementation of school mandates can effectively
increase immunization coverage levels among
pre-adolescents - School mandates can reduce disparities in
completion rates between different
races/ethnicities
19Recommendations
- Continue to educate providers, parents, and
schools about the law - Conduct similar review of immunization records of
7th grade students enrolled in Los Angeles County
schools
20Immunization Program 3530 Wilshire Bl. Suite
700 Los Angeles, CA 90010 Phone (213)
351-7800 Fax (213) 351-2780 www.lapublichealth.or
g/ip/