November 21, 2017
2 min read

Infant vaccination rates remain high despite racial, insurance disparities

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Although vaccination rates remain at or over 90% for many 19- to 35-month-old children, decreases in several vaccines were observed between 2015 and 2016, with notable disparities observed regarding insurance status and socioeconomic status.

“Vaccination is the most effective intervention to reduce morbidity and mortality from vaccine-preventable diseases in young children,” Holly A. Hill, MD, PhD, from the immunization services division in the National Center for Immunization and Respiratory Diseases at the CDC, and colleagues wrote.

To examine immunization coverage in the United States for suggested pediatric vaccines in children between 19 and 35 months, the researchers gathered data collected from the 2016 National Immunization Survey-Child (NIS-Child). From this data, Hill and colleagues evaluated trends in coverage by month and year of birth through weighted linear regression.

 In 2016, at least 90% of children received three or more doses of poliovirus vaccine (91.9%); at least one dose of measles, mumps and rubella vaccine (91.1%); at least one dose of varicella vaccine (90.6%); and at least three doses of hepatitis B (HepB) vaccine (90.5%).

Despite the high coverage for these vaccines in 2016, a drop in coverage by one to two percentage points was observed from 2015 regarding three or more doses of diphtheria and tetanus toxoids and acellular pertussis vaccine, three or more doses of poliovirus vaccine, the primary Haemophilus influenzae type b series and three or more HepB doses. This trend was also detected for three or more and four or more doses of pneumococcal conjugate vaccine. Trends remained the same for other vaccines.

When coverage was analyzed according to birth month and year, no difference was observed once the children included in the 2015 and 2016 NIS-Child reached 2 years of age. Rates of vaccination were lower for non-Hispanic black children in 2016 for most immunizations when compared with those of white children. Children who lived below the federal poverty level were also less likely to be vaccinated than those at or above this level.

Insurance status was an important indicator of vaccination status, with uninsured children least likely (12.4-24.9 percentage points less) and children on Medicaid less likely (2.5-12.0 percentage points less) to be immunized than children on private insurance.

“Continued collaboration between CDC and state immunization programs to further elucidate and address disparities in coverage by poverty status should provide valuable information while strategies needed for improving access to and delivery of age-appropriate immunization are identified,” Hill and colleagues wrote. “Health care providers can increase vaccination coverage using evidence-based strategies such as provider reminders, standing orders to provide vaccination whenever appropriate and immunization information systems.” – by Katherine Bortz

Disclosures: The author reports no relevant financial disclosures.