Delays in immunizations of high-risk infants during the first two years of life: special care for the high-risk infant should not mean special immunization schedules.

Because experience in our newborn intensive care unit follow-up clinic since 1982 suggested that immunizations of newborn intensive care unit graduates in the first 2 years of life were inappropriately delayed, questionnaires were sent to families and to the four categories of primary care providers (family practitioners, pediatricians, local health clinics, and neonatalogists) in our region to assess immunization rates and practices. Delays in the first diphtheria, tetanus, and pertussis immunization and the polio vaccine were greater the less the birth weight and less the gestational age of the infant. Delays in subsequent immunizations were considerable and did not correlate with gestational age. A substantial proportion of primary care providers are not immunizing infants in compliance with the American Academy of Pediatrics recommendation, but some improvement is seen when the time period 1982 to 1986 is compared with 1987 to 1991.