Trends in Timely Vaccination Coverage Associated with Family Income

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe trends in timely vaccination coverage with DTaP/DTP, polio, and MMR

Background:
A main conclusion reached from the measles resurgence was that vaccines need to be administered on time. .

Objectives:
To evaluate trends in timely vaccination coverage.

Methods:
233,999 19-35 month old children sampled by the National Immunization Survey between 1995-2006 stratified by family income (≤135% of the federal poverty level (FPL) - low income; ≥400% of the FPL -high-income).

Results:
Among 19-35 months old children in 2006, the estimated percentage of children living in a low-income household was 70.2% for American Indian/Alaska natives, 65.5% for Hispanics, 60.9% for non-Hispanic blacks, 30.1% for Asians, and 25.7% for non-Hispanic whites. For annual birth cohorts born between 1992-2003, estimated coverage of 4+ doses of DTaP/DTP vaccine by 19 months of age increased from 69.1% to 79.0% among children living in high-income households, and from 55.7% to 68.1% among children living in low-income households. Estimated coverage of 3+ doses of polio by 19 months of age increased from 77.0% to 87.8% among children living in high-income households, and from 65.6% to 86.1% among children living in low-income households. Estimated coverage of 1+ doses of MMR by 16 months of age increased from 70.9% to 85.0% among children living in high-income households, and from 53.2% to 77.1% among children living in low-income households. For each successive annual birth cohort, estimated timely vaccination coverage was significantly lower among children living in a low-income household for each vaccine, with estimated differences in timely vaccination coverage between children living in high and low income households declining from 13.4% to 10.9% for DTaP/DTP; from 11.4% to 1.7% for polio, and from 17.7% to 7.9% for MMR.

Conclusions:
Disparities in timely vaccination coverage by family income continue to persist.