Private Provider
Immunization Assessments
in Indiana
2004 Assessment Results
Indiana State Department of Health
Judith A. Monroe, MD, State Health Commissioner
Sue Uhl, J.D., Deputy State Health Commissioner
Community and Family Health Services Commission
Vacant, Assistant Commissioner
Immunization Program
Michael Runau, M.S., Program Director
Charlene Graves, M.D., Medical Director
Primary Author
Megan Steiger, M.P.H., Epidemiologist
Immunization Program
Indiana State Department of Health
2 North Meridian Street
Indianapolis, IN 46204
Publication Date: 03/2005
Data in this report was collected from 519
CASA-based assessments completed
in private provider offices throughout Indiana
by the Indiana State Department of Healths
Immunization Program.
Preface
The Private Provider Assessments in Indiana report summarizes the results
from 519 assessments of immunization practices completed in the private health
care sector in Indiana for 2004. The assessments were conducted from January
through December 2004 in private provider practices, including single and
multiple physician practices enrolled in the Vaccines for Children (VFC)
Program. Two sites not enrolled in the VFC program were given courtesy
assessments requested by the private provider. In the 519 assessments, there
were 28 sites that received more than one Clinical Assessment Software
Application-based (CASA) assessment during the calendar year of 2003.
In order to be considered completely immunized by age two, each child must have
received 4 vaccinations for diphtheria, tetanus, and acellular pertussis (DTaP),
3 vaccinations for polio, the first measles, mumps, and rubella vaccine (MMR),
at least 3 vaccinations for Haemophilus influenzae type b (Hib), and 3
vaccinations for hepatitis B (HepB). The data contained in this report
represents the immunization coverage levels of children who were 24 to 35 months
of age at the time of the assessment.Highlights
Highlights
-
Five hundred nineteen private practices, composed of
approximately 1244 individual practitioners, received a CASA-based assessment
in 2004. Of those practices, 28 received 2 or more CASA-based immunization
assessments between January 1 and December 31 of 2004.
-
An estimated 40,261 children aged 24-35 months were considered
active patients of these providers at the time of the assessment.
-
Individual antigens and vaccine series completion levels for
diphtheria, tetanus, and pertussis (DTaP); Polio; measles, mumps, and rubella
(MMR); Haemophilus influenzae type b (Hib); and hepatitis B are presented in
Table 2.
-
On the 4 DTaP: 3 Polio: 1 MMR: 3 Hib (4:3:1:3) vaccination
series, 84.0% of two-year olds assessed were found to be up-to-date at 24
months of age. Two hundred eight (40.1%) of the providers had more than 90
percent of their children up-to-date on the 4:3:1:3 series by 24 months of
age.
-
On the 4 DTaP: 3 Polio: 1 MMR: 3 Hib: 3 HepB (4:3:1:3:3)
vaccination series, 82.6% of two-year olds assessed were found to be
up-to-date at 24 months of age. Two hundred three (39.1%) of the providers had
more than 90 percent of their children up-to-date on the 4:3:1:3:3 series by
24 months of age.
Summary Tables and Graphs
Table 1. Summary of private provider assessment results,
Indiana, 2004.
Number of private providers assessed: |
519 |
Number of physicians included in the assessments: |
1,244 |
Number of counties where private provider CASA assessments were completed: |
78 |
Number of two-year old children included in assessments: |
11,972 |
Estimated number of two-year old children who are active patients in practices assessed: |
40,261 |
Percent of these provider’s estimated two-year old patient population assessed: |
29.7% |
Table 2. Summary of individual antigen and vaccination
series completion levels, by 24 months of age, private provider assessments
(n=519), Indiana, 2004.
|
Total
%
complete |
INDIVIDUAL ANTIGENS |
|
3 DTaP (Diphtheria, Tetanus, Pertussis) |
98.3% |
4 DTaP (Diphtheria, Tetanus, Pertussis) |
87.6% |
3 Polio (Oral and Inactivated) |
94.0% |
1 MMR (Measles, Mumps, and Rubella) |
92.7% |
3 Haemophilus influenzae type b (Hib) |
97.0% |
3 HepB (Hepatitis B) |
95.1% |
VACCINATION SERIES |
|
4 DTaP: 3 Polio: 1 MMR |
84.4% |
4 DTaP: 3 Polio: 1 MMR: 3 Hib |
84.0% |
4 DTaP: 3 Polio: 1 MMR: 3 Hib: 3 HepB |
82.6% |
Table 3: Mean CASA assessment levels for private VFC
provider sites in Indiana for assessment years 2000 through 2004.
Overall Two-Year Old Sample Coverage
Levels |
Series |
2000 |
2001 |
2002 |
2003 |
2004 |
4:3:1 |
69.6% |
74.9% |
79.6% |
80.7% |
84.4% |
4:3:1:3 |
68.6% |
73.5% |
79.2% |
80.4% |
84.0% |
4:3:1:3:3 |
65.8% |
71.6% |
76.7% |
78.4% |
82.6% |
|
Figure 1: Mean Private Provider 4:3:1, 4:3:1:3 and
4:3:1:3:3 coverage levels for assessment years 2000 (n=438), 2001 (n=499*)
2002 (n=538), 2003 (n=513**), and 2004 (n=519***) assessments.
* Includes 3 CASAs using hybrid method (unable to do
statistical analysis on this methodology, therefore, not included in these
statistics).
** Includes 3 CASAs completed at non-VFC provider sites
*** Includes 2 CASAs completed at non-VFC provider sites |
|
Figure 2: 4 DTaP: 3 Polio: 1 MMR: 3 Hib coverage levels
at 24 months of age, private provider assessments, Indiana, 2003 (n=513)
and 2004 (n=519). |
|
Figure 3: 4 DTaP: 3 Polio: 1 MMR: 3 Hib: 3 HepB
coverage levels at 24 months of age, private provider assessments,
Indiana, 2003 (n=513) and 2004 (n=519) |
Recommendations and Conclusions
-
Considerable increases in immunization coverage levels
for private providers were experienced during the 2004 assessment year
in the 4:3:1; 4:3:1:3; and 4:3:1:3:3 immunization series.
-
A significant number of private providers have shifted
to immunization coverage levels at or above 90 percent on the 4:3:1:3
and 4:3:1:3:3 series. Private providers with immunization rates above 90
percent demonstrate strong immunization practices and focus toward
improving the health of children in Indiana.
-
Providers need to remain up-to-date on ACIP
recommendations in regard to the childhood immunization schedule. VFC
providers are notified by the Immunization Program (i.e. through
informational updates) when updates have been made to the schedule. A
current copy of the Recommended Childhood Immunization Schedule is
available through the VFC program or can be accessed on the Immunization
Program website (http://in.gov/isdh/programs/immunization.htm).
|