Immunization Index  |  Data and Statistics

Private Provider Immunization Assessments in Indiana

2002 Assessment Results

Indiana State Department of Health

Gregory A. Wilson, M.D., State Health Commissioner
M. Elizabeth Carroll, J.D., Deputy State Health Commissioner

Community and Family Health Services Commission

Wendy Gettelfinger, R.N., D.N.S., J.D., 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: 08/2003

Preface

The Private Provider Assessments in Indiana report summarizes the results from 538 assessments of immunization practices completed in the private health care sector in Indiana for 2002. The assessments were conducted from January through December 2002 in private provider practices, including single and multiple physician practices who were enrolled in the Vaccines for Children (VFC) Program. In the 538 assessments, there were 30 sites who received more than one Clinical Assessment Software Application-based (CASA) assessment during the calendar year of 2002.

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

• Five hundred thirty-eight private practices, representing 1027 physicians, received a CASA-based immunization assessment in 2002; 30 of those private practices received two CASA-based immunization assessments in 2002.
• An estimated 24,548 children aged 24 – 35 months were considered active patients of these providers at the time of the assessments.
• For the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine series, 41.6% of assessed providers had more than 90 percent of their two-year old patients up-to-date at 24 months.
• For the polio vaccine series, 63.6% of assessed providers had more than 90 percent of their two-year old patients up-to-date at 24 months of age.
• For the measles, mumps, and rubella (MMR) vaccine series, 55.0% of assessed providers had more than 90 percent of their two-year old patients up-to-date at 24 months of age.
• For the Haemophilus influenza type b (Hib) vaccine series, 78.8% of assessed providers had more than 90 percent of their two-year old patients up-to-date at 24 months of age.
• On the 4 DTaP: 3 Polio: 1 MMR: 3 Hib (4:3:1:3) vaccination series, 79.4% of two-year olds seen at these were found to be up-to-date at 24 months of age.
• For the 4 DTaP: 3 Polio: 1 MMR: 3 Hib vaccination series, 32.0% of assessed providers had more than 90 percent of their two-year old patients up-to-date at 24 months of age.
• For the hepatitis B vaccine series, 65.0% of assessed providers had more than 90 percent of their two-year old patients up-to-date at 24 months of age.
• A significant drop in coverage of 14.9% between the first and final doses of the DTaP vaccine in a majority of private provider practices.
• A drop in coverage of 4.8% occurred between the first and final doses of the hepatitis B vaccine in private provider practices.

Summary Tables and Graphs

Table 1. Summary of private provider assessment results, Indiana, 2002.

Table 2. Summary of individual antigen and vaccination series completion levels, by 24 months of age,

private provider assessments (n=538), Indiana, 2002.

Figure 1: Mean Private Provider 4:3:1, 4:3:1:3 and 4:3:1:3:3 coverage levels; 1998 (n=112), 1999 (n=215), 2000 (n=438), 2001 (n=499*) and 2002 (n=538) assessments.

*Includes 3 CASAs using hybrid method (unable to do statistical analysis on this methodology, therefore, not included in these statistics).

Figure 2: 4 DTaP: 3 Polio: 1 MMR: 3 Hib coverage levels at 24 months of age, private provider assessments, Indiana, 2001 (n=502) and 2002 (n=538).

Table 3. Drop in coverage for DTaP and hepatitis B vaccination series, private provider Assessments (n=538), Indiana, 2002.

Figure 3: Median coverage levels of successive DTaP vaccinations, private provider assessments (n=538), Indiana, 2002.

Recommendations and Conclusions

• Only 79.3% of two-year old children seen by these private providers received 4 DTaP, 3 Polio, 1 MMR, and 3 Hib vaccines by 24 months of age. Immunization coverage levels must improve to ensure children throughout Indiana are protected against vaccine preventable disease.
• Private providers enrolled in the VFC program with high immunization coverage levels are applauded for their work in getting children immunized.
• Private providers with low immunization coverage levels should work carefully to improve their vaccination coverage rates.
• Proper documentation of immunizations administered by all of a child’s providers, showing the date, type, and lot number of each dose administered should be strictly maintained. Better documentation will lead to a clearer understanding of which areas of immunization practices need to be addressed to help raise coverage levels statewide.
• Continued evaluation/assessment of immunization practices will help to improve coverage levels.
• All providers must use the accelerated schedule for children who fall behind the normal recommended immunization schedule. The accelerated schedule can be found on the ISDH Immunization website (https://www.in.gov/isdh/programs/immunization.htm).
• The drops between the first and final doses of DTaP and hepatitis B have improved since last year, but more needs to be done to reduce the difference between these doses.

Data in this report was collected from 538 CASA-based assessments completed in private provider offices throughout Indiana by the Indiana State Department of Health’s Immunization Program.