Barbara H. Bardenheier1, Husain Yusuf
2, Jorge Rosenthal
3, Dr. Jeanne Santoli
4, Abigail Shefer
3, Donna L. Rickert
5, and Susan Chu
6. (1) NIP/ISD/HSREB, CDC, 1600 Clifton Rd, NE, MS-E52, Atlanta, GA, USA, (2) National Immunization Program / CDC, 1600 Clifton Road, MS-E52, Atlanta, Ga, USA, (3) Centers for Disease Control and Prevention, National Immunization Program, 1600 Clifton Road, NE, MS E-52, Atlanta, USA, (4) National Immunization Program, CDC, (5) ISD-HSREB, CDC - NIP, 1600 Clifton RD NE, Mailstop E-52, Atlanta, GA, USA, (6) National Immunization Program, Centers for Disease Control, 1600 Clifton Road, Mailstop E-62, Atlanta, GA, USA
KEYWORDS:
vaccination, risk factors for underimmunization, missed opportunities, WIC
BACKGROUND:
Although immunization rates are high nationwide, coverage in some urban areas remains below the national average. A 'late start' of the initial vaccination series is has been shown to be predictive of not be UTD at 12 and 24 months.
OBJECTIVE:
Determine coverage rates at 3 months of age and factors associated with underimmunization in four underserved areas in the United States.
METHOD:
Cross-sectional household surveys with a cluster sample design were conducted with independent samples from four sites in the Community Health Network Childhood Immunization Demonstration Project (CHN). 847, 843, 771, and 1091 parents of children aged 12-35 months from northern Manhattan, Detroit, San Diego, and rural Colorado, respectively. A child was considered up-to-date (UTD) with vaccinations at three months if documentation for DTP/DTaP, IPV/OPV, Hib, and Hepatitis B (1:1:1:1) were reported by the provider or if the dates of administration for each vaccine were documented in the parent-held vaccination card.
RESULT:
Household response rates were 79-88%. Vaccination coverage varied across sites: 82.4% in northern Manhattan, 70.5% in Detroit, 82.3% in San Diego, and 75.8% in Colorado. Among children who were not UTD, the majority (65.7 - 71.5% per site) were missing vaccines due to missed opportunities. Selected factors associated with not being UTD included having public or no insurance, having > 2 children, and the mother being unmarried. In all sites, coverage among WIC enrollees was higher than coverage among children eligible for but not enrolled in WIC.
CONCLUSION:
Missed opportunities remain a significant barrier to immunizations. Practice-based strategies and immunization-promoting WIC interventions should be especially focused at those of highest risk of underimmunization.
LEARNING OBJECTIVES:
Identify those at highest risk of underimmunization in the four sites and use practice-based strategies and immunization-promoting WIC interventions to increase immunization coverage.
See more of Why Children in Underserved Areas are Receiving Vaccinations Late: Programs Implemented to Increase Coverage Rates in Pocket of Need Areas
See more of The 37th National Immunization Conference
