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Poliovirus Infections
PEDIATRICS Vol. 111 No. 2 February 2003, pp. 296-301

Polio Extraimmunization in Children Younger Than 2 Years After Changes in Immunization Recommendations

Objective. To investigate trends over time in polio extraimmunization among children in 4 large health maintenance organizations and to study the association with recent changes in polio immunization policy.

Methods. Using 176 169 children who were born after 1994 and enrolled for their first 2 years of life, we assessed rates and trends of polio extraimmunization in the Vaccine Safety Datalink project. We used logistic regression to test the association of extraimmunization with different polio immunization schedules and with sociodemographic characteristics and used Poisson regression to test changes in rates over time.

Results. Overall, 10.5% were extraimmunized for poliovirus; children on the all inactivated polio virus or sequential schedule were one half as likely as those on the all oral polio virus schedule to be extraimmunized by 2 years of age. There was a significant decrease in extraimmunization over time, with <5% of children born at the end of 1997 being extraimmunized, compared with >15% at the beginning of 1994.

Conclusions. Poliovirus extraimmunization rates have fallen dramatically in association with the change-over to the all inactivated polio virus schedule.

Loren K. Mell, BS*,{ddagger}, Robert L. Davis, MD, MPH*,§, John P. Mullooly, PhD||, Steven B. Black, MD, Henry R. Shinefield, MD, Kenneth M. Zangwill, MD#, Joel I. Ward, MD#, S. Michael Marcy, MD**, Robert T. Chen, MD{ddagger}{ddagger} for the CDC Vaccine Safety Datalink Project

* Center for Health Studies, Group Health Cooperative, Seattle, Washington
{ddagger} University of Chicago, Pritzker School of Medicine, Chicago, Illinois
§ University of Washington, Departments of Pediatrics and Epidemiology, Seattle, Washington
|| Center for Health Research, Northwest Kaiser Permanente, Portland, Oregon
Division of Research, Kaiser Permanente of Northern California, Oakland, California
# UCLA Center for Vaccine Research, Harbor-UCLA Medical Center, Torrance, California
** Kaiser-UCLA Vaccine Research Group, Southern California Kaiser, Permanente, Panorama City, California
{ddagger}{ddagger} National Immunization Program, Vaccine Safety and Development Activity, Centers for Disease Control and Prevention, Atlanta, Georgia

Key Words: extraimmunization • polio vaccine

Abbreviations: OPV, oral polio virus • IPV, inactivated polio virus • DTP, diphtheria and tetanus toxoids and whole-cell pertussis • DTaP, diphtheria and tetanus toxoids and acellular pertussis • Hib, Haemophilus influenzae type b • HBV, hepatitis B virus • MMR, measles-mumps-rubella • HMO, health maintenance organization • GHC, Group Health Cooperative of Puget Sound • SCK, Southern California Kaiser Permanente Health Care Program • NCK, Northern California Kaiser Permanente Health Care Program • NWK, Kaiser Permanente Northwest

Received for publication Jun 3, 2002; Accepted Sep 23, 2002.




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L. K. Mell, D. S. Ogren, R. L. Davis, J. P. Mullooly, S. B. Black, H. R. Shinefield, K. M. Zangwill, J. I. Ward, S. M. Marcy, R. T. Chen, et al.
Compliance With National Immunization Guidelines for Children Younger Than 2 Years, 1996-1999
Pediatrics, February 1, 2005; 115(2): 461 - 467.
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