[Failures to comply with the routine childhood immunization schedule due to contraindications and the use of alternative vaccines in children aged 0-4 years in the Czech Republic]. / Príciny vynecáni pravidelného ockování z duvodu kontraindikace a pouzití alternativních vakcín u detí ve veku 0-4 roky v Ceské republice.

The study objective was to determine the rate of failures to present for routine childhood immunization due to either parental vaccine refusal, failure to comply with the immunization schedule and real or false contraindications. The rate of use of alternative vaccines which can be provided within the routine immunization schedule either on parental request or when recommended by the physician was also determined. We analyzed records of 5,038 children born between January 1, 2000 and December 31, 2004 and registered with a sample of general practitioners. We identified 1,284 cases (25.5 %) of no, incomplete or alternative vaccination. Failure to present for immunization with at least one vaccine as scheduled due to contraindication was stated in 291 (5.8 %) children; a total of 436 contraindications were reported (more than 1 contraindication in some children). The most common contraindication was a CNS disorder (171 cases) such as encephalopathy, epilepsy or unspecified conditions. Sixty-nine children (1.4 %) remained nonvaccinated against at least one disease (due to parental vaccine refusal or failure to comply with the immunization schedule). Alternative vaccines were administered to 936 (18.5 %) children for the following reasons: contraindication in 275 (5.5 %) children and on parental request in 716 (14.2 %) children (cost incurred by parents), with 55 (1.1 %) children given alternative vaccines for both reasons. These results suggest that contraindications and the use of alternative vaccines are quite common and need to be monitored.