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Children's Vaccines Health Center

One in Five Children May Get Extra Vaccinations, Study Finds

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March 7, 2000 (Cleveland) -- With all the attention given to the need for proper immunization of children, extra vaccinations may seem like a nonissue. But a study that appears in the March 8 issue of the Journal of the American Medical Association shows that one in five children 1 1/2 to 3 years old may get at least one shot they don't need.

There is no evidence that children could be harmed by extra doses of most routine vaccines, the study says. But, the researchers note, unneeded vaccinations are costly. What may help, according to the study's authors, is better record keeping by both parents and physicians.

The researchers took information from the 1997 National Immunization Survey, which was gathered from more than 32,000 children aged 19 to 35 months. Parents were interviewed by phone, and shot records were obtained from these children's private doctors or public health clinics.

Researchers found that 53% of the children were properly immunized, and 21% had been given an extra dose of at least one vaccine. A third of the children, they found, were lacking at least one vaccine. Extra immunizations were most common in children whose parents reported their vaccination history from a shot card, and in those with more than one doctor providing immunizations.

The complexity of the recommended vaccination schedules may cause confusion for both physicians and parents, the authors say.

The message for parents, says co-author R. Monina Klevens, DDS, MPH, is that "they can be responsible for making sure their children are appropriately immunized. They should take their children to the doctor regularly for shots ... familiarize themselves with the recommended immunization schedules, and the vaccines their children are receiving.

"Parents can also keep their own copy of their child's shot card," she says. "This will help to remind them when shots are due and show which shots their child has received. Parents can then share this information with their child's immunization provider." Klevens is with the assessment branch of the National Immunization Program of the CDC.

The study results, however, should not change current immunization practices. "For parents and physicians who need to decide what to do with this new information now, it is important to recognize that the risk of withholding vaccinations still far outweighs concerns about cost or the small added risk of adverse events associated with extraimmunization," Robert L. Davis, MD, MPH, writes in an editorial accompanying the article.

Davis, who is associate professor in pediatrics and epidemiology at the University of Washington in Seattle and associate investigator at the Center for Health Studies at Group Health Cooperative, sounds a wake-up call for good record keeping.

"Proper immunization practice is grounded on the availability of accurate and timely historical vaccination information," he tells WebMD. "There is a clear need for a nationally standardized, easily used immunization form in order to reduce confusion and error."

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