Vaccination Coverage and Barriers In Hard to Reach Children In South Korea

Background: While vaccination coverage among children has improved dramatically through the implementation of national immunization program in South Korea, risk for underimmunization of vulnerable children is generally considered higher than non-vulnerable children.

Objectives: To assess vaccination coverage and barriers associated with immunization among hard to reach children such as children from multi-cultural families, children in welfare facilities, and disabled children in Republic of Korea.

Methods: This study was based on data collected in September to December 2009, with 700 caretakers of hard to reach children aged 2-5. The vaccination coverage was surveyed along with possible demographic, socioeconomic and medical barrier factors of immunization. The survey questionnaire was created for each group and for the multi-cultural families, it was translated into 5 different languages. The participants were recruited upon an informed consent and the survey was carried out by trained interviewers. A selected sample of the participants was included in the focus group study upon informed consent.

Results: Vaccination coverage of the hard to reach children was lower than the non-vulnerable children within the community. There were also specific barrier factors to immunization for each group. For the multi-cultural group, short period of residence in Korea and having difficulty communicating in Korean were significant risk factors to underimmunization. For disabled children, types of insurance and severity of the disability were risk factors. For children in welfare facilities, residing in lone parent facility and not having an immunization record upon entry to the facility were significant factors.

Conclusions: Effective measures to deliver information, home visits of the community health center, improvement in the public transport arena, and comprehensive national policies directed towards welfare facilities are required in order to increase the vaccination coverage among these hard to reach population.