This month, we publish the recommended vaccine administration schedule, developed by the American Academy of Pediatrics Committee on Infectious Diseases (10.1542/peds.2019-3995). Important advances in vaccines prompts us to publish the revised guideline each year. How well are our patients adhering to this schedule? Hargreaves et al (10.1542/peds.2019-0783) evaluated the 2014 National Immunization Survey. The authors evaluated the degree to which non-evidence based “alternate schedules” were followed (e.g., limiting vaccines per visit, skipping one series of vaccines) or if patients were receiving vaccines in a pattern suggesting an “unknown” or “unclassifiable schedule”.
This study revealed that only 63% of vaccines given were administered according to the recommended schedule, with 23% following an “alternate” pattern and 14% unclassifiable. Only 58% of children were up to date with all recommended vaccines by 19 to 35 months of age. Does this high percentage of children off the recommended schedule surprise you? Does it worry you in regard to the high number of young children at risk for preventable illnesses? The authors provide much more data and analysis than this blog can provide, so link to their study and determine how your immunization practices compare. Adhering to the scientifically based recommended vaccine schedule is an ideal quality improvement project that could not only get you American Board of Pediatrics part 4 maintenance of certification credit, but most importantly protect the children in your community from preventable diseases.
