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Objective. Low childhood immunization rates have been a challenge in Colorado, an issue that was exacerbated by a diphtheria-tetanus-acellular pertussis (DTaP) vaccine shortage that began in 2001. To combat this shortage, the locally based Tri-County Health Department conducted a study to assess immunization-related barriers among children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk for undervaccination. Methods. This study assessed characteristics and perceptions of WIC mothers in conjunction with their children's immunization status in four clinics. Results. Results indicated poor immunization rates, which improved with assessment and referral. The uninsured were at higher risk for undervaccination. DTaP was the most commonly missing vaccine, and discrepancies existed between the children's perceived and actual immunization status, particularly regarding DTaP. Targeted interventions were initiated as a result of this study. Conclusion. Local health departments should target immunization-related interventions by assessing their own WlC populations to identify unique vaccine- related deficiencies, misperceptions, and high-risk subpopulations. [ABSTRACT FROM AUTHOR]