Hepatitis B and MMR Vaccine Coverage Levels Among Children Entering 7th Grade in Los Angeles County - PowerPoint PPT Presentation

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Hepatitis B and MMR Vaccine Coverage Levels Among Children Entering 7th Grade in Los Angeles County

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Title: Hepatitis B and MMR Vaccine Coverage Levels Among Children Entering 7th Grade in Los Angeles County


1
Hepatitis 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

2
Background
  • 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

3
Background
  • 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

4
Sample Assessment Form
IMMUNIZATION ASSESSMENT OF SEVENTH GRADE STUDENTS
481
7TH GRADE ENROLLMENT
5
7th Grade Immunization Assessment Results, Fall
1999
PME is Permanent Medical Exemption and PBE
is Personal Beliefs Exemption
6
Objective
  • 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

7
Methods
  • 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

8
Methods
  • 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

9
Methods
  • 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

10
ResultsRace/Ethnicity of Studentsn 5,103
11
ResultsCompletion Rates at Specific Age Intervals
12
Coverage Levels for 3 Doses of Hepatitis B
Vaccine (HBV)by Race and Age
13
Coverage Levels for 1 Dose of Measles Containing
Vaccine (MCV)by Race and Age
14
Coverage Levels for 2 Doses of Measles Containing
Vaccine (MCV)by Race and Age
15
Discussion
  • 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

16
Discussion
  • 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

17
Discussion
  • 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

18
Conclusion
  • 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

19
Recommendations
  • 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

20
Immunization Program 3530 Wilshire Bl. Suite
700 Los Angeles, CA 90010 Phone (213)
351-7800 Fax (213) 351-2780 www.lapublichealth.or
g/ip/
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