Immunization Index  |  Data and Statistics

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).