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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2004.053413v1 96/4/697    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Groom, A. V. Articles by Bryan, R. T. Search for Related Content PubMed PubMed Citation Articles by Groom, A. V. Articles by Bryan, R. T. Related Collections Health Policy Access to Care Immunization/Vaccines Prevention Other Child and Adolescent Health Native Americans Rural Health

Amy V. Groom, MPH, James E. Cheek, MD, MPH and Ralph T. Bryan, MD

Amy V. Groom is with the Program Operations Branch, Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga, and is field assigned to the Division of Epidemiology and Disease Prevention, Office of Public Health Support, Indian Health Service, Albuquerque, NM. James E. Cheek is with the Division of Epidemiology and Disease Prevention, Office of Public Health Support, Indian Health Service. Ralph T. Bryan is with the Office of Minority Health and Health Disparities, Office of Strategy and Innovation, Office of the Director, Centers for Disease Control and Prevention, and is field assigned to the Division of Epidemiology and Disease Prevention, Office of Public Health Support, Indian Health Service.

Correspondence: Requests for reprints should be sent to Ralph T. Bryan, MD, OMHD/OSI/OD, Centers for Disease Control and Prevention, c/o Indian Health Service, Division of Epidemiology and Disease Prevention, 5300 Homestead Rd NE, Albuquerque, NM 87110 (e-mail: rrb2{at}cdc.gov).

Objectives. We determined the effect of national vaccine shortages on coverage with 4 doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine for American Indian/Alaska Native (AIAN) children.

Methods. Data on DTaP coverage for children aged 19 to 27 months were abstracted from Indian Health Service (IHS) immunization reports. Coverage with the fourth DTaP dose (DTaP4) was compared for different periods to determine coverage levels before, during, and after the shortage. Data were stratified geographically to determine regional variation.

Results. AIAN children experienced a significant decline (14.8%) in DTaP4 coverage during the shortage. Considerable variation was seen among IHS regions (declines ranged from 4.5% to 26.5%).

Conclusions. AIAN children included in IHS immunization reports experienced a greater decline in DTaP4 coverage during the shortage than the decline reported nationally for children receiving vaccine at public clinics (14.8% vs 6%). Variations in the decline in coverage highlight possible inequities in vaccine supply and distribution and in implementation of vaccine shortage recommendations. We must identify ways to ensure more equitable vaccine distribution and consistent implementation of vaccine recommendations to protect all children from vaccine-preventable diseases.

This article has been cited by other articles:

				M. C. Lindley, A. V. Groom, P. M. Wortley, and G. L. Euler Status of Influenza and Pneumococcal Vaccination Among Older American Indians and Alaska Natives Am J Public Health, May 1, 2008; 98(5): 932 - 938. [Abstract] [Full Text] [PDF]

				A. V. Groom, M. L. Washington, P. J. Smith, and R. T. Bryan Underimmunization of American Indian and Alaska Native Children Pediatrics, May 1, 2008; 121(5): 938 - 944. [Abstract] [Full Text] [PDF]