{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T13:17:00Z","timestamp":1746710220755,"version":"3.40.5"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,6,1]]},"abstract":"<jats:p>Objective.\u2003Our earlier research found that the strongest predictor of not being up to date on the full series of immunizations by 24 months is failure to receive the first diphtheria vaccine and tetanus toxoid and pertussis vaccine (DTP1) on time. To learn more about the relationship between successful vaccination during the DTP1 age-appropriate (DTP1-AA) period (between 42 and 92 days of life, inclusive) and an infant's early visit to the physician (before 42 days of life), we quantified children's progression through a sequence of provider visits and outcomes.<\/jats:p><jats:p>Design.\u2003This study analyzed data from 426 children living in the 57 poorest census tracts in Baltimore. For each DTP1-AA visit, we calculated the percentage of times a DTP1-AA vaccination, provider missed opportunity, or deferral for a valid contraindication occurred. Relative and attributable risks were computed to assess associations between DTP1-AA vaccination and early visits and missed opportunities.<\/jats:p><jats:p>Results.\u2003We found the following: 1) Children who made a visit before 42 days of life were more than twice as likely to receive a DTP1-AA vaccination; 2) the missed opportunity rate for children who did not make an early visit was approximately twice that of the early-visit group; and 3) well visits were more likely to result in DTP1-AA immunization than sick visits. Attributable risk calculations show that DTP1-AA vaccination rates could be increased in this population by one third if all infants had an early visit.<\/jats:p><jats:p>Conclusions.\u2003Early in-office visits seem to make DTP1-AA vaccination more likely. These rates may be amenable to intervention by increasing early visits and reducing DTP1-AA missed opportunities. Introduction of the hepatitis B vaccine to the recommended series may place more emphasis on early visits and result in increased DTP1-AA rates and, ultimately, higher vaccination coverage rates.<\/jats:p>","DOI":"10.1542\/peds.101.6.970","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"970-974","source":"Crossref","is-referenced-by-count":14,"title":["Initiating the First DTP Vaccination Age-appropriately: A Model for Understanding Vaccination Coverage"],"prefix":"10.1542","volume":"101","author":[{"given":"Alan","family":"Ross","sequence":"first","affiliation":[{"name":"From the Departments of Biostatistics,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne Baber","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Maternal and Child Health, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Holt","sequence":"additional","affiliation":[{"name":"International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Guyer","sequence":"additional","affiliation":[{"name":"Maternal and Child Health, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Hou","sequence":"additional","affiliation":[{"name":"Maternal and Child Health, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Hughart","sequence":"additional","affiliation":[{"name":"Maternal and Child Health, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[1998,6,1]]},"reference":[{"key":"2021121000185053400_B1","first-page":"176","article-title":"National, state, and urban area vaccination coverage levels among children aged 19\u201335 months\u2014United States\u2014January\u2013December 1995.","volume":"46","author":"Centers for Disease Control and Prevention","year":"1997","journal-title":"MMWR"},{"key":"2021121000185053400_B2","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1542\/peds.94.1.53","article-title":"Immunization coverage and its relationship to preventive health care visits among inner-city children in Baltimore.","volume":"94","author":"Guyer","year":"1994","journal-title":"Pediatrics"},{"key":"2021121000185053400_B3","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1001\/jama.1994.03510350043035","article-title":"Low vaccination levels of US preschool and school-age children. 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