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Vaccination Coverage Disparities Between Foreign-Born and U.S.-Born Children Aged 19–35 Months, United States, 2010–2012

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Abstract

Healthy People 2020 targets high vaccination coverage among children. Although reductions in coverage disparities by race/ethnicity have been described, data by nativity are limited. The National Immunization Survey is a random-digit-dialed telephone survey that estimates vaccination coverage among U.S. children aged 19–35 months. We assessed coverage among 52,441 children from pooled 2010–2012 data for individual vaccines and the combined 4:3:1:3*:3:1:4 series (which includes ≥4 doses of diphtheria, tetanus, and acellular pertussis vaccine/diphtheria and tetanus toxoids vaccine/diphtheria, tetanus toxoids, and pertussis vaccine, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, ≥3 or ≥4 doses of Haemophilus influenzae type b vaccine (depending on product type of vaccine; denoted as 3* in the series name), ≥3 doses of hepatitis B vaccine, ≥1 dose of varicella vaccine, and ≥4 doses of pneumococcal conjugate vaccine). Coverage estimates controlling for sociodemographic factors and multivariable logistic regression modeling for 4:3:1:3*:3:1:4 series completion are presented. Significantly lower coverage among foreign-born children was detected for DTaP, hepatitis A, hepatitis B, Hib, pneumococcal conjugate, and rotavirus vaccines, and for the combined series. Series completion disparities persisted after control for demographic, access-to-care, poverty, and language effects. Substantial and potentially widening disparities in vaccination coverage exist among foreign-born children. Improved immunization strategies targeting this population and continued vaccination coverage monitoring by nativity are needed.

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Notes

  1. The 4:3:1:3 vaccine series includes ≥4 doses of DTaP/diphtheria and tetanus toxoids vaccine/diphtheria, tetanus toxoids, and pertussis vaccine, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, and ≥3 doses of Hib vaccine of any type.

References

  1. Department of Health and Human Services. Healthy People 2020 Topics & Objectives: immunization and infectious diseases. Updated April 1, 2015. https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives. Accessed 4 Apr 2015.

  2. Centers for Disease Control and Prevention. Reported vaccine-preventable diseases–United States, 1993, and the childhood immunization initiative. Morbidity Mortal Wkly Rep. 1994;43(4):57–60.

    Google Scholar 

  3. Whitney CG, Zhou F, Singleton J, Schuchat A. Benefits from immunization during the Vaccines for Children program era—United States, 1994–2013. Morbidity Mortal Wkly Rep. 2014;63:352–5.

    Google Scholar 

  4. Groom AV, Washington ML, Smith PJ, Bryan RT. Underimmunization of American Indian and Alaska Native children. Pediatrics. 2008;121(5):938–44.

    Article  PubMed  Google Scholar 

  5. Groom AV, Santibanez TA, Bryan RT. Vaccination Coverage Among American Indian and Alaska Native Children, 2006–2010. Pediatrics. 2012;130:e1592.

    Article  PubMed  Google Scholar 

  6. Zhao Z, Smith PJ. Trends in vaccination coverage disparities among children, United States, 2001–2010. Vaccine. 2013;31(19):2324–7.

    Article  PubMed  Google Scholar 

  7. Elam-Evans LD, Yankey D, Singleton JA, Kolasa M. National, state, and selected local area vaccination coverage among children aged 19–35 months—United States, 2013. Morbidity Mortal Wkly Rep. 2014;63(34):741–8.

    Google Scholar 

  8. Department of Homeland Security. 2012 Yearbook of immigration statistics. Published 2013. http://www.dhs.gov/sites/default/files/publications/ois_yb_2012.pdf. Accessed 24 Jan 2014.

  9. Motel S, Patten E. Statistical portait of the foreign population in the United States, 2011. Published January 29, 2013. http://www.pewhispanic.org/2013/01/29/statistical-portrait-of-the-foreign-born-population-in-the-united-states-2011/. Accessed 10 Dec 2014.

  10. World Health Organization. Immunization, vaccines and biologicals: data, statistics and graphics. Updated February 23, 2015. http://www.who.int/immunization/monitoring_surveillance/data/en/. Accessed 12 Mar 2015.

  11. Strine TW, Barker LE, Mokdad AH, Luman ET, Sutter RW, Chu SY. Vaccination coverage of foreign-born children 19 to 35 months of age: findings from the National Immunization Survey, 1999–2000. Pediatrics. 2002;110(2):e15.

    Article  PubMed  Google Scholar 

  12. Findley SE, Irigoyen M, Schulman A. Children on the move and vaccination coverage in a low-income, urban Latino population. Am J Public Health. 1999;89(11):1728–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Borràs E, Domínguez A, Batalla J, Torner N, Cardeñosa N, Nebot M, et al. Vaccination coverage in indigenous and immigrant children under 3 years of age in Catalonia (Spain). Vaccine. 2007;25(16):3240–3.

    Article  PubMed  Google Scholar 

  14. Chiaradia G, Gualano MR, Di Thiene D, Galli L, Giacchino R, Gattinara GC, et al. Health status of immigrant children: an epidemiological survey among Italian paediatricians. Ital J Public Health. 2012;8(3):268–74.

    Google Scholar 

  15. van der Wal MF, Diepenmaat ACM, Pel JM, Hirasing RA. Vaccination rates in a multicultural population. Arch Dis Child. 2005;90(1):36–40.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Poethko-Müller C, Ellert U, Kuhnert R, Neuhauser H, Schlaud M, Schenk L. Vaccination coverage against measles in German-born and foreign-born children and identification of unvaccinated subgroups in Germany. Vaccine. 2009;27(19):2563–9.

    Article  PubMed  Google Scholar 

  17. Poethko-Müller C, Mankertz A. Sero-epidemiology of measles-specific IgG antibodies and predictive factors for low or missing titres in a German population-based cross-sectional study in children and adolescents (KiGGS). Vaccine. 2011;29(45):7949–59.

    Article  PubMed  Google Scholar 

  18. NHMRC Centre of Research Excellence in Population Health Research. Protecting Australia—closing the gap in immunisation for migrants and refugees: Proceedings from a stakeholder workshop. Published 2013. http://creimmunisation.com.au/sites/default/files/newsevents/events/Proceedings_CREMigrantRefugeeWorkshop.pdf. Accessed 24 Dec 2014.

  19. National Foundation for Infectious Diseases. A report on reaching underserved ethnic and minority populations to improve pediatric immunization rates. Published 2002. http://www.nfid.org/publications/reports/pediatricwhitepaper.pdf. Accessed 23 Dec 2014.

  20. Kiros G-E, White MJ. Migration, community context, and child immunization in Ethiopia. Soc Sci Med. 2004;59(12):2603–16.

    Article  PubMed  Google Scholar 

  21. Kusuma YS, Kumari R, Pandav CS, Gupta SK. Migration and immunization: determinants of childhood immunization uptake among socioeconomically disadvantaged migrants in Delhi. India Trop Med Int Health. 2010;15(11):1326–32.

    Article  PubMed  Google Scholar 

  22. Lu P-J, Rodriguez-Lainz A, O’Halloran A, Greby S, Williams WW. Adult vaccination disparities among foreign-born populations in the US, 2012. Am J Prev Med. 2014;47(6):722–33.

    Article  PubMed  Google Scholar 

  23. Centers for Disease Control and Prevention. National Immunization Survey: a user’s guide for the 2012 public-use data file. Published February 2014. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NIS/NISPUF12_DUG.PDF. Accessed 22 Mar 2015.

  24. Centers for Disease Control and Prevention. Adding Households with Cell Phone Service to the National Immunization Survey (NIS), 2011. Updated September 6, 2012. http://www.cdc.gov/vaccines/imz-managers/coverage/nis/child/dual-frame-sampling.html. Accessed 22 Mar 2015.

  25. Walker AT, Smith PJ, Kolasa M. Reduction of racial/ethnic disparities in vaccination coverage, 1995–2011. Morbidity Mortal Wkly Rep. 2014;63(1):7–12.

    Google Scholar 

  26. Zhao Z, Luman ET. Progress toward eliminating disparities in vaccination coverage among US children, 2000–2008. Am J Prev Med. 2010;38(2):127–37.

    Article  CAS  PubMed  Google Scholar 

  27. World Health Organization. WHO vaccine-preventable diseases: monitoring system 2014 global summary. Updated 2014. http://apps.who.int/immunization_monitoring/globalsummary/diseases. Accessed 11 Dec 2014.

  28. Centers for Disease Control and Prevention. Global Routine Vaccination Coverage—2012. Morbidity Mortal Wkly Rep. 2013;62(43):858–61.

    Google Scholar 

  29. Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012;30(12):2212–9.

    Article  CAS  PubMed  Google Scholar 

  30. Komatsu H. Hepatitis B virus: where do we stand and what is the next step for eradication? World J Gastroenterol. 2014;20(27):8998–9016.

    PubMed  PubMed Central  Google Scholar 

  31. Centers for Disease Control and Prevention. Catch-up immunization schedule for persons aged 4 months through 18 years who start late or who are more than 1 month behind—United States, 2015. Updated January 28, 2015. http://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html. Accessed 4 Apr 2014.

  32. Centers for Disease Control and Prevention. Technical Instructions for Panel Physicians and Civil Surgeons. Updated August 21, 2014. http://www.cdc.gov/immigrantrefugeehealth/exams/ti/panel/vaccination-panel-technical-instructions.html. Accessed 22 Mar 2015.

  33. Bonanni P, Breuer J, Gershon A, Gershon M, Hryniewicz W, Papaevangelou V, et al. Varicella vaccination in Europe–taking the practical approach. BMC Med. 2009;7(1):26.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Centers for Disease Control and Prevention. Updates to the overseas immunization program for United States–bound refugees. Morbidity Mortal Wkly Rep. 2015;64(1):31.

    Google Scholar 

  35. Robert Wood Johnson Foundation. Living in America: challenges facing new immigrants and refugees. Published 2006. http://research.policyarchive.org/21623.pdf. Accessed 24 Mar 2015.

  36. Buelow VH, Van Hook J. Timely immunization series completion among children of immigrants. J Immigr Minor Health. 2008;10(1):37–44.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Ku L. Improving health insurance and access to care for children in immigrant families. Ambul Pediatr. 2007;7(6):412–20.

    Article  PubMed  Google Scholar 

  38. Ku L, Matani S. Left out: immigrants’ access to health care and insurance. Health Aff. 2001;20(1):247–56.

    Article  CAS  Google Scholar 

  39. Glatman-Freedman A, Nichols K. The effect of social determinants on immunization programs. Hum Vaccin Immunother. 2012;8(3):293–301.

    Article  PubMed  Google Scholar 

  40. Bosch-Capblanch X, Banerjee K, Burton A. Unvaccinated children in years of increasing coverage: how many and who are they? Evidence from 96 low-and middle-income countries. Trop Med Int Health. 2012;17(6):697–710.

    Article  PubMed  Google Scholar 

  41. Perreira KM, Crosnoe R, Fortuny K, Pedroza J, Ulvestad K, Weiland C, et al. Barriers to immigrants’ access to health and human services. Published 2012. http://www.urban.org/publications/413260.html. Accessed 24 Mar 2015.

  42. Pylypchuk Y, Hudson J. Immigrants and the use of preventive care in the United States. Health Econ. 2009;18(7):783–806.

    Article  PubMed  Google Scholar 

  43. Derose KP, Bahney BW, Lurie N, Escarce JJ. Immigrants and health care access, quality, and cost. Med Care Res Rev. 2009;66(4):355–408.

    Article  PubMed  Google Scholar 

  44. Community Preventive Services Task Force. The guide to community preventive services: increasing appropriate vaccination. Updated February 13, 2015. http://www.thecommunityguide.org/vaccines/index.html. Accessed 3 Apr 2015.

  45. Smith PJ, Lindley MC, Rodewald LE. Vaccination coverage among US children aged 19–35 months entitled by the Vaccines for Children program, 2009. Public Health Rep. 2011;126(Suppl 2):109–23.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Centers for Disease Control and Prevention. About VFC. Updated February 14, 2014. http://www.cdc.gov/vaccines/programs/vfc/about/index.html. Accessed 26 Jan 2015.

  47. Stanwyck CA, Kolasa MS, Shaw KM. Immunization requirements for childcare programs: are they enough? Am J Prev Med. 2004;27(2):161–3.

    Article  PubMed  Google Scholar 

  48. Davis MM, Gaglia MA. Associations of daycare and school entry vaccination requirements with varicella immunization rates. Vaccine. 2005;23(23):3053–60.

    Article  PubMed  Google Scholar 

  49. Magnuson K, Lahaie C, Waldfogel J. Preschool and School Readiness of Children of Immigrants. Soc Sci Q. 2006;87(5):1241–62.

    Article  Google Scholar 

  50. Capps R, Fix M, Murray J, Ost J, Passel JS, Herwantoro S. The new demography of America’s Schools: immigration and the No Child Left Behind Act. Published 2005. http://www.urban.org/publications/311230.html. Accessed 15 Mar 2015.

  51. Centers for Disease Control and Prevention. 2014 Binational immunization resource tool for children from birth through 18 years. Updated February 23, 2015. http://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html. Accessed 4 Apr 2015.

  52. Centers for Disease Control and Prevention. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity Mortal Wkly Rep. 2011;60(RR02):1–60.

    Google Scholar 

  53. U.S. Census Bureau. 2008–2012 American Community Survey 5-year Estimates, Table S0501—Selected Characteristics of the Native and Foreign-born Populations. Updated 2015. http://factfinder.census.gov/. Accessed 3 Apr 2015.

  54. Chu SY, Barker LE, Smith PJ. Racial/ethnic disparities in preschool immunizations: United States, 1996–2001. Am J Public Health. 2004;94(6):973–7.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We would like to acknowledge Dr. James A. Singleton for his critical review of this manuscript and valuable analytic suggestions. Aiden K. Varan was supported in part by an appointment to the Applied Epidemiology Fellowship Program administered by the Council of State and Territorial Epidemiologists (CSTE) and funded by Centers for Disease Control and Prevention (CDC) Cooperative Agreement Number 1U380T000143-01. No financial disclosures were reported by any authors of this paper. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of CDC.

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Authors and Affiliations

  1. CDC/CSTE Applied Epidemiology Fellowship Program, Atlanta, GA, USA

    Aiden K. Varan

  2. Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, 3851 Rosecrans St, Suite 715, San Diego, CA, 92110, USA

    Aiden K. Varan & Alfonso Rodriguez-Lainz

  3. County of San Diego Health and Human Services Agency, San Diego, CA, USA

    Aiden K. Varan

  4. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA

    Holly A. Hill, Laurie D. Elam-Evans, David Yankey & Qian Li

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  1. Aiden K. Varan
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  2. Alfonso Rodriguez-Lainz
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Correspondence to Alfonso Rodriguez-Lainz.

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Varan, A.K., Rodriguez-Lainz, A., Hill, H.A. et al. Vaccination Coverage Disparities Between Foreign-Born and U.S.-Born Children Aged 19–35 Months, United States, 2010–2012. J Immigrant Minority Health 19, 779–789 (2017). https://doi.org/10.1007/s10903-016-0465-4

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