Influenza vaccine coverage and missed opportunities among inner-city children aged 6 to 23 months: 2000-2005

OBJECTIVE. In 2002, the Advisory Committee on Immunization Practices recommended universal influenza vaccination of 6- to 23- month- olds. Little is known about coverage and missed opportunities for influenza vaccination at inner- city practices. The objective of this study was to assess the 2000 - 2001 to 2004 - 2005 coverage and the prevalence of missed opportunities for influenza vaccination among inner- city children. METHODS. We conducted a retrospective review for the 2000 - 2001 to 2004 - 2005 influenza seasons at a practice network in New York City. The study population included 5 annual cohorts of 6- to 29- month olds as of March 31 of each year with >= 1 visit to the network in the previous 12 months ( n = 7063). Immunization data were obtained from the network registry and the New York Citywide Immunization Registry. Coverage levels were estimated for 1 dose ( partial) and 2 doses ( full). Missed opportunities were assessed for visits within each influenza season. RESULTS. Coverage rose steadily throughout the 5 years ( full: 1.6% to 23.7%; partial: 1.5% to 18.1%). The relationship between year and coverage was linear. Missed opportunities occurred in 82% of visits and were more common for first ( 89%) than for repeat doses ( 38%). Missed opportunities per child per season decreased from 2.9 to 2.0 during the study period. CONCLUSIONS. Influenza vaccine coverage among 6- to 23- month- olds at inner- city practices increased steadily from 2000 - 2001 through 2004 - 2005, and the prevalence of missed opportunities per child decreased. However, coverage remained suboptimal, with most of children not vaccinated or undervaccinated. Missed opportunities were major contributors to low coverage.