Sara J Whitehead1, Kate X Cui, Anindya K De, Tracy Ayers, Paul V Effler. 1. Preventive Medicine Residency Program, Career Development Division, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. svw7@cdc.gov
Abstract
OBJECTIVE: Obtaining childhood immunization coverage data for small geographic areas is difficult and resource-intensive, especially in the absence of comprehensive immunization registries. To identify factors that are associated with delayed immunization, we collected school-entry immunization records statewide and used geocoding to link to publicly available census tract sociodemographic data. METHODS: Immunization records were reviewed for children who were enrolled in all public and private school kindergarten programs in Hawaii in the 2002-2003 school year; immunization status at the time of the second birthday was determined. The main outcome variable was up-to-date status for the 4:3:1:3:3 vaccination series (4 doses of diphtheria-tetanus-pertussis, 3 doses of polio, 1 dose of measles-mumps-rubella, 3 doses of Haemophilus influenzae type b, and 3 doses of hepatitis B vaccines). Children's home addresses were geocoded to census tracts; coverage rates by tract were mapped, and sociodemographic data from Census 2000 files were used to identify factors that were associated with delays in immunization. RESULTS: Records were obtained for 15,275 of 15,594 children registered in Hawaii kindergartens. Overall, 78% had completed their 4:3:1:3:3 series by their second birthday. Risk factors for delayed immunization included delayed immunization at 3 months of age, living in Maui County, living in a neighborhood where a low proportion of adults had postsecondary education, and living in a neighborhood where a high proportion of households spoke a language other than English at home. The majority (80%) of underimmunized children would have required only 1 additional visit to bring them up-to-date. CONCLUSIONS: Retrospective review of kindergarten-entry immunization data revealed geographic areas with lower immunization coverage, and geocoding to census tracts identified associated sociodemographic risk factors. This is a practical method for state or city health departments to identify pockets of need and to direct resources appropriately.
OBJECTIVE: Obtaining childhood immunization coverage data for small geographic areas is difficult and resource-intensive, especially in the absence of comprehensive immunization registries. To identify factors that are associated with delayed immunization, we collected school-entry immunization records statewide and used geocoding to link to publicly available census tract sociodemographic data. METHODS: Immunization records were reviewed for children who were enrolled in all public and private school kindergarten programs in Hawaii in the 2002-2003 school year; immunization status at the time of the second birthday was determined. The main outcome variable was up-to-date status for the 4:3:1:3:3 vaccination series (4 doses of diphtheria-tetanus-pertussis, 3 doses of polio, 1 dose of measles-mumps-rubella, 3 doses of Haemophilus influenzae type b, and 3 doses of hepatitis B vaccines). Children's home addresses were geocoded to census tracts; coverage rates by tract were mapped, and sociodemographic data from Census 2000 files were used to identify factors that were associated with delays in immunization. RESULTS: Records were obtained for 15,275 of 15,594 children registered in Hawaii kindergartens. Overall, 78% had completed their 4:3:1:3:3 series by their second birthday. Risk factors for delayed immunization included delayed immunization at 3 months of age, living in Maui County, living in a neighborhood where a low proportion of adults had postsecondary education, and living in a neighborhood where a high proportion of households spoke a language other than English at home. The majority (80%) of underimmunized children would have required only 1 additional visit to bring them up-to-date. CONCLUSIONS: Retrospective review of kindergarten-entry immunization data revealed geographic areas with lower immunization coverage, and geocoding to census tracts identified associated sociodemographic risk factors. This is a practical method for state or city health departments to identify pockets of need and to direct resources appropriately.
Authors: Deron C Burton; Brendan Flannery; Nancy M Bennett; Monica M Farley; Ken Gershman; Lee H Harrison; Ruth Lynfield; Susan Petit; Arthur L Reingold; William Schaffner; Ann Thomas; Brian D Plikaytis; Charles E Rose; Cynthia G Whitney; Anne Schuchat Journal: Am J Public Health Date: 2010-08-19 Impact factor: 9.308
Authors: Alyna T Chien; Joseph P Newhouse; Lisa I Iezzoni; Carter R Petty; Sharon-Lise T Normand; Mark A Schuster Journal: Pediatrics Date: 2017-10-03 Impact factor: 7.124
Authors: Jessica A Kattan; Kathy S Kudish; Betsy L Cadwell; Kristen Soto; James L Hadler Journal: Am J Public Health Date: 2013-11-14 Impact factor: 9.308