The 36th National Immunization Conference of CDC

Wednesday, May 1, 2002 - 10:40 AM

Risk Factors for Under-Immunization in Urban and Non-Urban Areas, NIS 1999

Ram B. Jain, Ali H. Mokdad, Lawrence E. Barker, and Susan Chu. National Immunization Program, Centers for Disease Control, 1600 Clifton Road, Mailstop E-62, Atlanta, GA, USA

Under-Immunization, Risk Factors, Racial Disparities, National Immunization Survey, Urban Areas

Many factors, such as race, income, inter-state mobility and others, are known to influence vaccination coverage on a national level. Many cultural and sociological factors separate urban and non-urban areas. It is not known if these factors affect vaccine coverage differently in urban and non-urban settings.

To determine how risk factors associated with under-immunization differ in urban and non-urban areas.

The National Immunization Survey (NIS) is a large, ongoing, cross-sectional telephone survey of non-institutionalized civilians. We used the 1999 NIS data to compare rates of under-immunization for children living in urban and non-urban areas. We used logistic regression to assess risk factors associated with under-immunization, with completion of the 4:3:1:3:3 series.

In 1999, under-immunization rates for urban and non-urban areas were 30.5% and 25.8% respectively (p<.01). Income and race were not statistically significantly associated with under-immunization after controlling for other potential confounders in both urban and non-urban areas. Order of birth, motherís age, and availability of shot card were associated with under-immunization in both urban and non-urban areas. Inter-state mobility was associated with increased under-immunization rates in urban areas but not in non-urban areas. Motherís education, marital status, number and type of providers were associated with under-immunization in non-urban areas but not in urban areas.

Under-immunization rates, and risk factors for under-immunization, are not the same in urban and non-urban areas. These differences should be considered when developing targeted interventions to increase vaccination coverage.

1. Determine the risk factors that adversely affect immunization rates.
2. Compare the risk factors for under-immunization in urban and non-urban areas.

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