1880. Age-Appropriate Compliance and Completion of Pertussis Vaccination in US Children
Session: Poster Abstract Session: Vaccines: Pertussis
Saturday, October 10, 2015
Room: Poster Hall
Background: In the US, primary diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccination is recommended at ages 2, 4, and 6 months; with booster doses at 15–18 months and 4–6 years. Undervaccination, whether due to delayed or missed doses, may leave children vulnerable to infection. Study objectives were to examine compliance to, and completion of, 3-, 4-, and 5-dose series of DTaP in commercially insured (C-I) and Medicaid (M) children in the US and identify predictors of compliance and completion.

Methods: Truven Health MarketScan® 2005–2013 Commercial and Multi-State Medicaid claims databases were analyzed. Children born during 2005–2011 with ≥2 years continuous enrollment from birth were included (providing data on doses 1–4), as was a subgroup of children with continuous enrollment from birth to their 7th birthday (providing data on dose 5). Series compliance (doses 1–3 at 1.2–3.0, 2.2–5.0, 3.1–7.0 months; dose 4 at 11.9–19.0 months; dose 5 before 7th birthday) and series completion (3 doses by 8 months; 4 doses by 24 months; 5 doses by 7th birthday) were calculated. Predictors of completion and compliance were identified in multivariate models (C-I & M data were analyzed separately). 

Results: The study included 367,493 C-I and 766,153 M children followed until ≥2 years of age and 23,574 C-I and 41,284 M children followed until 7 years of age. Series compliances to doses 1–3, 1–4, and 1–5 were 67.2%, 55.3%, and 47.5% (C-I) and 37.4%, 27.3%, and 14.4% (M), respectively. Series compliance increased from 2005 to 2011 (doses 1–3: 64.0% to 70.8% [C-I] and 29.7% to 45.4% [M]; doses 1–4: 52.4% to 58.5% [C-I] and 18.9% to 33.3% [M]). Completions of 3-, 4-, and 5-dose series were 73.7%, 70.3%, and 63.0% (C-I) and 46.5%, 44.7%, and 29.1% (M), respectively. Predictors of improved compliance/completion included: more recent birth year (C-I & M) and higher household income (C-I); while predictors of worse compliance/completion included: Northeast residence (C-I), Black race (M), and birth hospitalization stay ≥14 days (C-I & M).

Conclusion: Although compliance and completion with DTaP vaccination improved over time, they remained suboptimal for both groups, especially children covered by Medicaid.

Girishanthy Krishnarajah, Ph.D.1, Elisabetta Malangone-Monaco, MS2, Liisa Palmer, PhD3, Ellen Riehle, MPH2 and Philip Buck, PhD4, (1)US Health Outcomes & Epidemiology - Vaccines USMA Health Outcomes, GlaxoSmithKline: USHO Vaccines, Philadelphia, PA, (2)Truven Health Analytics, Bethesda, MD, (3)Outcomes Research, Truven Health Analytics, Bethesda, MD, (4)GlaxoSmithKline, Philadelphia, PA


G. Krishnarajah, GSK: Employee and Shareholder , Salary

E. Malangone-Monaco, GSK: Consultant , Research support

L. Palmer, GSK: Consultant , Research support

E. Riehle, GSK: Consultant , Research support

P. Buck, GSK: Employee and Shareholder , Salary

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