THE IMMUNIZATION STATUS OF CHILDREN WITH SPINA-BIFIDA

Objective.-To estimate immunization levels among children with spina bifida and describe factors that may influence immunization completeness. Research Design.-Cross-sectional survey. Setting.-Tertiary care referral center. Patients.-One hundred twenty children, from 4 months to 18 years of age, seen in the myelodysplasia clinic of Children's Hospital, Boston, Mass, from February through August 1990. Results.-Fifty-eight percent of the children 2 years of age or older and 55% of the children 7 years of age or older had completed the immunization series recommended by the American Academy of Pediatrics. All but one child had an identified primary care provider. Lower immunization levels at 24 months of age occurred in older and in poorer children. Most children (80%) received the first diphtheria and tetanus toxoids and pertussis and oral poliovirus vaccines on time. Immunization delay increased from 20% to 50% through the 18-month diphtheria and tetanus toxoids and pertussis and oral poliovirus vaccines and declined to 24% at school entry. Conclusions.-Many children with spina bifida are underimmunized despite having an identified source of primary care.