Philip J. Smith, NIP, CDC, 1600 Clifton Rd, Mailstop E-62, Atlanta, GA, USA, Diane M. Simpson, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mailstop E-62, Atlanta, Georgia, USA, Lance Rodewald, Centers for Disease Control and Prevention, National Immunization Program, 1600 Clifton Road, NE, MS E-52, Atlanta, Georgia, USA, and Lawrence E. Barker, National Immunization Program, Centers for Disease Control, 1600 Clifton Road, Mailstop E-62, Atlanta, GA, USA.
KEYWORDS:
Health insurance coverage; parental knowledge and experiences about vaccination; day care arrangements.
BACKGROUND:
In addition to monitoring vaccination uptake, information on barriers to vaccination is required to improve vaccination coverage rates.
OBJECTIVE:
To describe results from the National Immunization Survey (NIS) about potential barriers. These include the relationship between vaccination coverage and (i) health insurance coverage; (ii) parental knowledge and experiences about vaccination; and (iii) day care arrangements.
METHOD:
A split sampling design was in the NIS used to collect information about each of the three topics.
RESULT:
Nationally, 92.2% (±1.4%) of all children 19-35 months of age were covered by some type of health insurance. Vaccination coverage for the 4:3:1:3 vaccination series (4 or more doses of diphtheria and tetanus toxoids and pertussis vaccine; 3 or more doses of poliovirus vaccine; 1 or more doses of measles-containing vaccine; and 3 or more doses of Haemophilus influenzae type b vaccine) was 17.1% (±9.4%) less among children without health insurance than those with health insurance. Perceptions pertaining to vaccine safety were not significantly different among parents whose child was 4:3:1:3 up-to-date (UTD) than among parents whose child was not 4:3:1:3 UTD (p=0.24). Finally, 39.4% (±5.2%) of all children 19-32 months of age attend day care. The 4:3:1:3 coverage rate among children attending day care was approximately 8.6% greater among children who attended daycare on a regular bases compared to those who did not (p=0.08).
CONCLUSION:
Parental perceptions regarding vaccine safety currently have little bearing on whether their child is adequately vaccinated. However, children who were not covered by health insurance or have never attended day care may be at risk for underimmunization.
LEARNING OBJECTIVES:
These findings may serve as a starting point for designing programs to increase vaccination rates among children who are less well vaccinated.
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