{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:13:38Z","timestamp":1790914418440,"version":"4.1.0"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,10,1]]},"abstract":"<jats:p>Despite many recent advances in vaccine delivery, the goal for universal immunization set in 1977 has not been reached. In 2001, only 77.2% of US toddlers 19 to 35 months of age had received their basic immunization series of 4 doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, 3 doses of inactivated poliovirus vaccine, 1 dose of measles-mumps-rubella (MMR) vaccine, and 3 doses of Haemophilus influenzae type b (Hib) vaccine. Children who are members of a racial or ethnic minority, who are poor, or who live in inner-city or rural areas have lower immunization rates than do children in the general population. Additional challenges to vaccine delivery include the introduction of new childhood vaccines, ensuring a dependable supply of vaccines, bolstering public confidence in vaccine safety, and sufficient compensation for vaccine administration.<\/jats:p><jats:p>Recent research has demonstrated specific and practical changes physicians can make to improve their practices\u2019 effectiveness in immunizing children, including the following: 1) sending parent reminders for upcoming visits and recall notices; 2) using prompts during all office visits to remind parents and staff about immunizations needed at that visit; 3) repeatedly measuring practice-wide immunization rates over time as part of a quality improvement effort; and 4) having in place standing orders for registered nurses, physician assistants, and medical assistants to identify opportunities to administer vaccines. Pediatricians should work individually and collectively at local and national levels to ensure that all children receive all childhood immunizations on time. Pediatricians also can proactively communicate with parents to ensure they understand the overall safety and efficacy of vaccines.<\/jats:p>","DOI":"10.1542\/peds.112.4.993","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"993-996","source":"Crossref","is-referenced-by-count":26,"title":["Increasing Immunization Coverage"],"prefix":"10.1542","volume":"112","author":[{"name":"Committee on Community Health Services and Committee on Practice and Ambulatory Medicine","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,10,1]]},"reference":[{"key":"2021121003420168400_R1","unstructured":"American Academy of Pediatrics, Committee on Standards of Child Health Care. AAP National Immunization Policy. AAP News and Comment.October 1977;28:7\u20138"},{"key":"2021121003420168400_R2","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Practice and Ambulatory Medicine. Implementation of the immunization policy. Pediatrics.1995;96:360\u2013361","DOI":"10.1542\/peds.96.2.360"},{"key":"2021121003420168400_R3","doi-asserted-by":"crossref","unstructured":"Wood DL, Halfon N. The impact of the Vaccine for Children\u2019s Program on child immunization delivery. A policy analysis. Arch Pediatr Adolesc Med.1996;150:577\u2013581","DOI":"10.1001\/archpedi.1996.02170310011001"},{"key":"2021121003420168400_R4","unstructured":"Centers for Disease Control and Prevention. Recommendations of the Advisory Committee on Immunization Practices: programmatic strategies to increase vaccination coverage by age 2 years\u2014linkage of vaccination and WIC services. 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Available at: http:\/\/www.niaid.nih.gov\/publications\/pdf\/jordan.pdf. Accessed January 1, 2003"},{"key":"2021121003420168400_R9","doi-asserted-by":"crossref","unstructured":"Wolfe RM, Sharp LK, Lipsky MS. Content and design attributes of antivaccination Web sites. JAMA.2002;287:3245\u20133248","DOI":"10.1001\/jama.287.24.3245"},{"key":"2021121003420168400_R10","doi-asserted-by":"crossref","unstructured":"Carlin E, Carlson R, Nordin J. Using continuous quality improvement tools to improve pediatrics immunization rates. Jt Comm J Qual Improv.1996;22:277\u2013288","DOI":"10.1016\/S1070-3241(16)30231-0"},{"key":"2021121003420168400_R11","doi-asserted-by":"crossref","unstructured":"Sinn JS, Morrow AL, Finch AB. Improving immunization rates in private pediatric practices through physician leadership. Arch Pediatr Adolesc Med.1999;153:597\u2013603","DOI":"10.1001\/archpedi.153.6.597"},{"key":"2021121003420168400_R12","doi-asserted-by":"crossref","unstructured":"LeBaron CW, Chaney M, Baughman AL, et al. Impact of measurement and feedback on vaccination coverage in public clinics, 1988\u20131994. JAMA.1997;277:631\u2013635","DOI":"10.1001\/jama.277.8.631"},{"key":"2021121003420168400_R13","doi-asserted-by":"crossref","unstructured":"Briss PA, Rodewald LE, Hinman AR, et al. Reviews of the evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. Am J Prev Med.2000;18(1 suppl):97\u2013140","DOI":"10.1016\/S0749-3797(99)00118-X"},{"key":"2021121003420168400_R14","doi-asserted-by":"crossref","unstructured":"Raddish M, Goldmann DA, Kaplan LC, Perrin JM. The immunization status of children with spina bifida. Am J Dis Child.1993;147:849\u2013853","DOI":"10.1001\/archpedi.1993.02160320051018"},{"key":"2021121003420168400_R15","unstructured":"National Childhood Vaccine Injury Act. Pub L No. 99-660 (1986)"},{"key":"2021121003420168400_R16","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. The medical home. Pediatrics.2002;110:184\u2013186","DOI":"10.1542\/peds.110.1.184"},{"key":"2021121003420168400_R17","doi-asserted-by":"crossref","unstructured":"Santoli JM, Rodewald LE, Maes EF, Battaglia MP, Coronado VG. Vaccines for Children Program, United States, 1997. Pediatrics. 1999;104(2). Available at: http:\/\/www.pediatrics.org\/cgi\/content\/full\/104\/2\/e15","DOI":"10.1542\/peds.104.2.e15"},{"key":"2021121003420168400_R18","unstructured":"American Academy of Pediatrics Childhood Immunization Support Program. Available at: http:\/\/www.cispimmunize.org. 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