DO PROVIDER PRACTICES CONFORM TO THE NEW PEDIATRIC IMMUNIZATION STANDARDS

Objective: Standards for pediatric immunization practices were issued by the Centers for Disease Control and Prevention, Atlanta, Ga, in May 1992. This article provides baseline data on immunization practices related to eight of the standards. Design: Survey of pediatric providers before publication of the standards. Setting: Baltimore, Md. Participants: Forty of the 41 health centers, clinics, and private practices serving children in designated highrisk census tracts participated in the survey. One hundred seventy-three of the 251 eligible physicians and nurse practitioners at the sites responded. Main Outcome Measures: Conformity with the eight standards was measured as a percentage of either sites or physicians and nurse practitioners across the sites. Results: Conformity with the standards varied, ranging from nearly universal conformity with the need to educate parents and guardians about immunizations (standard 5) to less than 3% for simultaneous administration of all vaccine doses when a child is first eligible (standard 8). For most of the standards, considerable variability was found between and within public and private sites. Conclusions: Providers often followed practices that did not conform to the new standards (prior to issuance). Some of the standards are ambiguous and require clarification before they can be fully applied. The impact of the standards on immunization rates and pediatric primary health care has yet to be tested empirically.