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AAP Grand Rounds 4:18-19 (2000) Effect of a Monetary Sanction on Immunization Rates of AFDC ChildrenSource: Kerpelman LC, Connell DB, Gunn WJ. Effect of a monetary sanction on immunization rates of recipients of Aid to Families with Dependent Children. JAMA. 2000;284:5359.
Immunization rates for poor and minority children remain suboptimal. In a randomized, controlled trial conducted from January 1993 through December 1996 in Muscogee County, Georgia, rates of immunization with MMR, poliovirus, DTP, Hib and hepatitis B in a total of 2,500 families were examined before and after imposition of a sanction. The intervention group consisted of 2,488 children in 1,500 families whose welfare benefits were made dependent on up-to-date immunization status. The control group consisted of 1,662 children in 1,000 families that were encouraged to fully immunize their children. The groups were initially matched for average number of children per family, ethnicity, age of children in the family, number of children born during the study, and baseline immunization rates. The immunization status of each child was verified through medical records. Sanctions consisted of losing AFDC benefits for the non-immunized child
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