Immunization Coverage for American Indian and Alaska Native Children

Background:
A previous study of National Immunization Survey (NIS) immunization coverage data from 2000 - 2005 found significant disparities in coverage for American Indian/Alaska Native (AI/AN) children compared to non-Hispanic whites during 2001-2004.

Objectives:
We used NIS data from 2005 – 2007 to determine if disparities exist and if being covered by Indian Health Service (IHS) affects immunization levels for AI/AN children.

Methods:
We calculated coverage with each vaccine in the 4:3:1:3:3:1 vaccine series for 2 groups of 19-35 month old children: those identified as AI/AN alone or in combination with another race (AI/AN), and those identified as non-Hispanic white (White). For the AI/AN group we compared immunization coverage between those who reported being covered by IHS to those who did not. Preliminary analysis is limited to 2007.

Results:
In 2007, AI/AN children (N=431) were significantly more likely to live in poverty, have younger mothers, and have mothers with lower educational levels compared to White children (N=10405). Less than a quarter (21.6%) of AI/AN children reported being covered by IHS. AI/AN children had significantly higher coverage with varicella vaccine compared to Whites (92.8% vs. 89.2%); differences in coverage with all other vaccines and vaccine series were not significant. Immunization coverage for AI/AN children covered by IHS was not significantly different from coverage for AI/AN children who were not covered by IHS.

Conclusions:
Preliminary analysis of data from the 2007 NIS suggest that the disparities identified in 2001-2004 are not present in 2007, and that AI/AN children may now have better coverage for some vaccines. Being covered by IHS did not appear to be associated with immunization coverage levels. Our finding that only 21% of AI/AN children reported being covered by IHS highlights the fact AI/AN children are served by a variety of providers, including but not limited to IHS.