Wednesday, January 23, 2013

Things is gettin' worser - Pediatric Undervaccination

The typical trajectory of public health over the past several centuries has pointed upwards towards improvements including longer life-expectency. However, as we've entered the post-scientific era, where our country receives its medical advice from celebrities, it's not at all surprising that things can move in the wrong direction. Of course, vaccines are a victim of their own successes since absence of a terrible diseases like measles convinces people they don't need to vaccinate their children and also more susceptible to false claims of vaccine side-effects, but I digress.

Authors Jason Glanz and colleagues recently published a matched-cohort study of healthcare utilization in vaccinated vs. under-vaccinated children less than 3 years old. Their primary findings were that undervaccinated children had lower rates of outpatient visits but higher rates of inpatient admissions.  There are also some interesting findings about how parental choice in vaccination is associated with healthcare utilization. What was more interesting to me is how things have changed gotten worse in the birth cohorts over the 5 years studied (2004 to 2008).  In the figure below, time to first vaccination has increased greatly over the 5 years (solid shapes), as have the rates of 'no vaccination'. So things are moving upward, but in this case, that's the wrong direction.



Reference: Glanz JM, Newcomer SR, Narwaney KJ, et al. A Population-Based Cohort Study of Undervaccination in 8 Managed Care Organizations Across the United States. JAMA Pediatr. 2013;():1-8. doi:10.1001/jamapediatrics.2013.502.

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