Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe immunization coverage in 28 selected urban areas by distinctive urban characteristics.

Background:
Demographic characteristics such as racial composition, percentage of children living below poverty, population diversity and population density may be associated with persistent immunization disparities in U.S. cities. The ranking of U.S. cities according to these characteristics may help disentangle the complexities of racial disparities in vaccination coverage.

Objectives:
To investigate immunization coverage rates in 28 selected urban areas according to socio-demographic indicators as reported by the U.S. Bureau of the Census.

Methods:
We used data from the 2003-2004 National Immunization Survey (NIS) conducted among households with children aged 19 to 35 months to assess vaccination coverage in 28 selected urban areas for the 4:3:1:3:3 vaccine series (4+ doses diphtheria and tetanus toxoids and pertussis vaccine, 3+ doses of any poliovirus vaccine, 1+ doses measles-containing vaccine, and 3+ doses Haemophilus Influenzae type b vaccine, 3+ doses of hepatitis B vaccine). Selected urban areas were ranked according to the socio-demographic indicators published in the 2000 U.S. Census report.

Results:
Vaccination coverage ranged from 76% in San Diego, CA to 90% in Washington, DC among white children; 66% in Detroit, MI to 87% in Boston, MA among black children; and 67% in Houston, TX to 89% in Boston, MA among Hispanic children. Disparity varied by characteristics of the 28 selected urban areas.

Conclusions:
Although ranking urban areas according to social indicators may oversimplify urban complexities, doing so can raise awareness of urban differences and provide policymakers with useful information to better evaluate the impact of these characteristics on immunization programs.