(HealthDay News) – From 2000–2011 there was an increase in the rate of religious vaccination exemptions in New York State, which correlated with increased incidence of pertussis; and missed immunizations should be given at sick visits and not delayed until make-up well-baby visits, according to research published online June 3 in Pediatrics.

Aamer Imdad, MD, from the State University of New York Upstate Medical University in Syracuse, and colleagues describe the rates of religious vaccination exemptions from 2000–2011 and the correlation with pertussis in New York State. The researchers found that the overall annual state mean prevalence of religious exemptions for one or more vaccines was 0.4% in the study period, and increased significantly from 0.23–0.45% in 2011. The incidence of pertussis was higher in counties with mean exemption prevalence rates of ≥1%.

To quantify the potential trade-off between giving immunizations at sick visits for minor and acute illness and well-baby visits, Steve G. Robinson, from Oregon Health Authority in Portland, conducted a retrospective cohort analysis involving 1,060 cases. Robinson found that, through 24 months, there was no significant difference in immunization rates or well-baby visits for those with or without sick-visit immunizations. 39% of infants seen for a sick visit who did not receive an immunization at that time failed to return for a make-up well-baby visit. This group also had fewer well-baby visits from 2–24 months and was significantly less likely to be up-to-date for immunizations (relative risk, 0.66).

“The substantial risk that infants will not return for a timely make-up well-baby visit after a sick visit should be included in any consideration of whether to delay immunizations,” Robinson writes.

One author from the Imdad study disclosed financial ties to the pharmaceutical industry, related to immunizations.

Abstract – Imdad
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Abstract – Robinson
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