Biomedical subjects

Maureen S Kolasa

Publications and source records attributed to Maureen S Kolasa.

5 recordsLinked to original sources

PubMed2004

Progress toward implementation of a second-dose measles immunization requirement for all schoolchildren in the United States.

In 1998, the Advisory Committee on Immunization Practices and the American Academy of Pediatrics recommended that states ensure that all children in grades kindergarten through 12 receive 2 doses of measles-mumps-rubella (MMR) vaccine by 2001. In 2000, the National Immunization Program surveyed states, the District of Columbia, and United States territories, commonwealths, and protectorates to assess progress toward this goal. Almost all respondents (53 [98%] of 54) reported a second-dose requirement for entry to elementary school, middle school, or both. By fall of 2001, most (82%) school-aged children in the United States were in grades requiring a second dose of measles vaccine. For 29 responding programs, the requirement did not yet affect all grades. By 2009, 52 of 54 responding programs will require a second dose for all grades. Although not all states have achieved coverage of all schoolchildren with 2 doses of MMR vaccine, most states are well on their way toward this goal.

Adolescent↗

PubMed2004

Immunization requirements for childcare programs. Are they enough?

BACKGROUND: School immunization legislation has resulted in high vaccination coverage rates and low rates of vaccine-preventable disease among school children. Similar legislation has been directed toward children in licensed and regulated childcare programs. The purpose of this investigation was to compare immunization coverage among children in and not in childcare. METHODS: For 18 months during 2001 and 2002, the National Immunization Survey (NIS), a random-digit-dialing telephone survey, collected information on children aged 19 through 35 months, including data on enrollment in childcare. Data were analyzed retrospectively to determine coverage at 24 months and at the time of the survey. Children were considered up-to-date if they had received all recommended immunizations for their age. RESULTS: Of the eligible NIS respondents, about 41% had a child in childcare at the time of or before the survey. Retrospective analysis of children at 24 months showed no significant differences in coverage between those in and not in childcare (73.1% vs 71.9%). Likewise, analysis of coverage at the time of the survey revealed no significant differences (76.4% vs 72.6%). CONCLUSIONS: Immunization legislation and regulations have been successful in increasing coverage rates in the school population. Similar legislation for childcare facilities appears not to have been as effective. Given these findings, it seems that new strategies are needed to increase coverage in preschool children.

Child Day Care Centers↗

PubMedDate not supplied

How complete are immunization registries? The Philadelphia story.

OBJECTIVE: To assess accuracy and completeness of Philadelphia, Pa, registry data among children served by providers in areas at risk for underimmunization. METHODS: Philadelphia's Department of Public Health selected a simple random sample of 45 children age 19-35 months (or all children age 19-35 months if there were <45 children in the practice) from each of 30 private practices receiving government-funded vaccine and located in zip codes where children are at risk for underimmunization. Chart and registry data were compared with determine the proportion of children missing from the registry and assess differences in immunization coverage. RESULTS: Of 620 children reviewed, 567 (92%) were in the registry. Significant differences (P < .05) were observed in immunization coverage for 4 diphtheria-tetanus-acellular pertussis vaccinations, 3 polio vaccinations, 1 measles-mumps-rubella vaccination, and 3 Haemophilus influenzae type b vaccinations between the chart (80% coverage) and registry (62% coverage). Providers submitting electronic medical records or directly transferring electronic data to the registry had significantly more children in the registry and higher registry-reported immunization coverage than those whose data were entered from billing records or log forms. All practice types experienced difficulties in transferring complete data to the registry. CONCLUSIONS: Although 92% of study children were in the registry, immunization coverage was significantly lower when registry data were compared with chart data. Because electronic medical records and direct electronic data transfer resulted in more complete registry data, these methods should be encouraged in linking providers with immunization registries.

Child↗

PubMedDate not supplied

Practice-based electronic billing systems and their impact on immunization registries.

Many providers rely on electronic billing systems to report information to immunization registries. If billing data fail to capture some administered immunizations, the registry will not reflect a child's true immunization status. Our objective was to assess differences between immunizations administered and immunizations reported to a registry from electronic billing systems. Philadelphia's Department of Public Health conducted chart audits in 45 providers serving 50 or more children aged 7-35 months and using electronic billing systems to report data to Philadelphia's immunization registry in 2001-2003. Chart records were compared to registry records to identify immunizations administered in these practices but not reported to the registry. The study practices administered 256,969 immunizations to 20,611 children. Of these 256,969 administered immunizations, 62,213 (24%) were not in the registry. The electronic billing systems submitted data for all administered immunizations for 69% of immunization visits, some but not all for 11% of visits, and none for 20% of visits. Immunizations administered but not billed cost these providers up to $980,477 in lost revenue from administrative fees alone. Improvement of billing data quality would result in more complete registries, higher reported immunization coverage rates, and recovered revenue for immunization providers.

Accounts Payable and Receivable↗

PubMedDate not supplied

Do laws bring children in child care centers up to date for immunizations?

BACKGROUND: Pennsylvania state law requires licensed child care centers (CCCs) to document that each enrolled child is up to date (UTD) for routine immunizations within 60 days of enrollment. This study evaluates the law's impact on immunization coverage among children aged <or=59 months who attend CCCs in Philadelphia. METHODS: Out of Philadelphia's 440 commercial CCCs, 75 were randomly selected. Of these, 9 had closed, 3 did not accept children aged <or=59 months, and 3 refused assessment. For the remaining 60 CCCs, vaccination dates were abstracted from CCC records for all enrolled children <or=59 months. For children not UTD for all vaccines according to CCC records, additional data were sought from Philadelphia's immunization registry, health care providers, and parents. RESULTS: Records of 2847 children were assessed. According to CCC records, information from the immunization registry, vaccination providers, and parents, 71% of children aged 0-18 months, 77% of children 19-35 months, and 84% of children 36-59 months were UTD for their age for diphtheria, tetanus toxoids, and pertussis vaccine; polio; Haemophilus influenzae type b; and measles, mumps, and rubella vaccines. No significant increase in immunization coverage levels was found between the date children enrolled in a CCC and 60 days later. CONCLUSIONS: Up to one quarter of children <5 years of age enrolled in Philadelphia's CCCs are not UTD for immunizations, with children 0-18 months of age being most behind in their immunizations. Furthermore, many children do not receive vaccines within 60 days of enrollment. These low coverage levels combined with the potential exposures inherent in group care settings indicate that children in CCCs are at risk for contracting vaccine-preventable diseases.

Child Day Care Centers↗