Age-appropriate compliance and completion of up to five doses of pertussis vaccine in US children. Issue 12 (2nd December 2018)

• Record Type: Journal Article
• Authors: Krishnarajah, Girishanthy; Malangone-Monaco, Elisabetta; Palmer, Liisa; Riehle, Ellen; Buck, Philip O.
• Is Part Of: Human vaccines & immunotherapeutics. Volume 14:Issue 12(2018)
• Page Start: 2932
• Page End: 2939
• Publication Date: 2018-12-02
• Subjects: Pertussis -- DTaP -- vaccination -- Medicaid -- children -- compliance -- United States; Vaccines -- Periodicals; 615.372
• DOI: 10.1080/21645515.2018.1502526
• Languages: English
• ISSNs: 2164-5515

Abstract

ABSTRACT: Background : In the United States (US), diphtheria, tetanus, and acellular pertussis (DTaP) vaccination is recommended at 2, 4, and 6 months (doses 1–3), 15–18 months (dose 4), and 4–6 years (dose 5). The objective of this study (GSK study identifier: HO-14–14383) was to examine DTaP completion and compliance rates among commercially insured and Medicaid-enrolled children. Secondarily, the study aimed at identifying predictors of compliance/completion. Methods : Truven Health MarketScan Commercial and Multi-State Medicaid databases (2005–2013) were analyzed separately. Children born during 2005–2011 with ≥ 2 years continuous enrollment from birth provided data for doses 1–4; those with continuous enrollment from birth to their seventh birthday provided dose 5 data. Series compliance (each recommended dose by 3, 5, and 7 months; 19 months; seventh birthday) and completion (3 doses by 8 months; 4 by 24 months; 5 by seventh birthday) were calculated. Predictors of compliance/completion were identified using multivariable logistic regression. Results : A total of 367, 493 commercially insured and 766, 153 Medicaid-enrolled children were followed for ≥ 2 years; and 23, 574 and 41, 284, respectively, for ≥ 7 years. Series compliance to doses 1–3, 1–4, and 1–5 were 67.2%, 55.3%, 47.5% (commercial) and 37.4%, 27.3%, 14.4% (Medicaid), respectively. Predictors of better compliance/completion included: later birth year (commercial/Medicaid) and higher household income (commercial); predictors of worse compliance/completion included: Northeast residence (commercial), birth hospitalization ≥ 14 days (commercial/Medicaid), and Black race/ethnicity (Medicaid). Conclusions : DTaP series compliance/completion improved over time, but appear to be suboptimal. As this could increase pertussis risk, greater awareness of the importance of timely vaccination completion is needed. GSK study identifier : HO-14–14383