National examination of compliance predictors and the immunization status of children: precursor to a developmental model for health systems.

OBJECTIVES: The gap between children's immunization requirements and actual compliance is staggering. Using a national survey instrument, the purpose of this study was to analyze the relationship between select predictors and immunization status in children between 19 months and 6 years of age. METHODS: From the 1998 Medical Expenditure Panel Survey, 1575 children were included in a multivariate logistical model. Outcomes were measured as compliance with approved vaccination regimens. RESULTS: Only 67% of children between 19 months and 6 years old were compliant with all recommended vaccines. However, nonminority children with health insurance from families with income above the federal poverty line or living outside a metropolitan statistical area were more likely to be vaccinated. Children of older or educated parents likewise tended to have complete immunization. CONCLUSIONS: Analyzing childhood immunization via parental characteristics identifies prevalent predictors of compliance. Outcomes suggest potential strategies for health systems to focus on children's health issues--specifically immunizations.