Background: Strategies to increase immunization rates often target compliance with pediatric standards of care.

Objective: This study examines the association between adherence to selected pediatric standards of care and immunization rates in publicly funded rural clinics.

Design/Methods: Adherence to pediatric standards of care(maintaining an immunization tracking system, administering immunizations at sick visits, having extended hours for immunizations, screening for immunizations at every visit, and administering recommended vaccines simultaneously) was determined through responses to a telephone survey administered to all 73 publicly funded rural immunization clinics in Colorado. Immunization rates for 51 of the sites were derived from chart audit data reported by the State of Colorado.

Results: Immunization levels ranged from 26% to 100% with a median of 67.6% and a mean of 62.9%. All of the publicly funded sites had some type of immunization tracking system. Eighty-four percent of the sites gave immunizations at sick visits, 76.7% of the sites had extended hours for immunizations, and 76.7% of the sites screened for immunizations at every visit. Only 56.2% of sites routinely gave vaccines simultaneously. The largest differences in immunization rates between sites that reported adherence to the standards of practice and sites that did not report adherence to the standards of practice were as follows: Sites with computerized tracking systems had higher immunization levels than sites with manual tracking systems (77.9% vs 69.4%, p =.08) and sites that screened for immunizations at every visit had higher immunization levels than those that did not (75.2% vs 68.1%, p=.19).

Conclusion: The impact of self-reported adherence to selected pediatric standards of care on immunization levels may be small. Additional research should assess actual compliance with standards of practice and examine the association between actual compliance and immunization rates.