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.
L. Palmer, GSK: Consultant , Research support
E. Riehle, GSK: Consultant , Research support
P. Buck, GSK: Employee and Shareholder , Salary