摘要：Objectives . This study sought to provide a characterization of US childhood vaccination providers. Methods . The state was used as the analytic unit in examining 1997 data from the National Immunization Survey and the Vaccines for Children program, state immunization reports, and natality records. Results . Overall, 57% of children were vaccinated in the private sector, 18% were vaccinated in the public sector, and 25% were vaccinated by a mixture of providers. Of the 50 883 immunization sites, 81% were private and 19% public. Average patient load was 77 infants per site. Private-sector patient loads were lower than public-sector loads. Conclusions . US childhood vaccination provider capacity is adequate. Efforts to raise coverage rates should focus on increasing preventive care use among children, improving the vaccination performance of providers, and ensuring continuity of care. Well-child care may be the most important opportunity for prevention in the clinical health care system, and vaccination is commonly regarded as a core function. 1 However, US immunization providers have never been characterized: How many practices and clinics provide vaccinations to children? How many children are served in the public and private sectors? What is the overall capacity of the system to deliver vaccinations to the birth cohort? How evenly is this capacity distributed? Two programs that had their first full year of implementation in 1995, the National Immunization Survey and the Vaccines for Children (VFC) program, made it possible to estimate provider counts on a state-by-state basis and thus answer these questions for the first time.
