Factors Associated with Underimmunization at 3 Months of Age in Four Medically Underserved Areas

Bardenheier, Barbara; Yusuf, Hussain; Rosenthal, Jorge; Santoli, Jeanne M.; Shefer, Abigail; Rickert, Donna; Chu, Susan Y.

doi:10.1016/j.phr.2004.07.005

Cited by 58 publications

(57 citation statements)

References 22 publications

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“…Additional factors previously noted in the literature to be associated with vaccination coverage were also entered into the models due to their potential theoretical importance. Such factors included child age, maternal age, maternal education, presence of a personal doctor or nurse, accessibility of services and discontinuous insurance coverage [15,[30][31][32][33]. All analyses were performed using SPSS version 17.0 (SPSS Inc. Chicago, Ill).…”

Section: Discussionmentioning

confidence: 99%

Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

et al. 2011

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Few studies have examined potential factors that contribute to low influenza vaccination rates among minority children. This study aimed to assess the prevalence of early childhood influenza vaccination among young black and Latino children, living in inner-city neighborhoods, and examine the effects of child, caregiver and health system factors. Secondary data analysis was performed using a survey about medical home experiences conducted from May 2007-June 2008. The study sample was limited to children ≥6 months in any influenza season prior to the 2006-2007 influenza season. Bivariate analyses and multivariable logistic regression tested associations between influenza vaccination receipt and socio-demographic and health system characteristics. One-third of children received an influenza vaccination by the end of 2006-2007 season, while only 11% received a vaccination within their first season of eligibility. Black children were more likely than Latino children to have been vaccinated (50% vs. 31%, P<0.01) during their first few eligible seasons. Children whose mothers were older, proficient in English, and frequent users of healthcare were more likely to obtain vaccination. Child attendance at healthcare settings with immunization reminder systems was also positively correlated with influenza vaccination. Our findings suggest that initial vaccination receipt among minority children from inner-city communities might be improved by expanded influenza promotion activities targeting younger mothers or those with limited English proficiency. Strategies to increase the frequency of child's actual contact with the medical home, such as reminder systems, may be useful in improving uptake of influenza vaccination among inner-city, minority children.

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Section: Discussionmentioning

confidence: 99%

Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

et al. 2011

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“…In the United States, despite great success of public health programs and availability of vaccines for disadvantaged children through the federally funded Vaccines for Children Program, many children in medically underserved areas as well as in minority groups remain partially immunized or nonimmunized (520). Recent (2015) data from Detroit, MI, show that only 40% of children have completed the primary vaccination series and suggest that rates of underimmunization may exceed 50% in some populations (Michigan Care Improvement Registry, unpublished data).…”

Section: Dtp and Dtap Vaccines For Infants And Young Childrenmentioning

confidence: 99%

Pertussis: Microbiology, Disease, Treatment, and Prevention

et al. 2016

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SUMMARYPertussis is a severe respiratory infection caused byBordetella pertussis, and in 2008, pertussis was associated with an estimated 16 million cases and 195,000 deaths globally. Sizeable outbreaks of pertussis have been reported over the past 5 years, and disease reemergence has been the focus of international attention to develop a deeper understanding of pathogen virulence and genetic evolution ofB. pertussisstrains. During the past 20 years, the scientific community has recognized pertussis among adults as well as infants and children. Increased recognition that older children and adolescents are at risk for disease and may transmitB. pertussisto younger siblings has underscored the need to better understand the role of innate, humoral, and cell-mediated immunity, including the role of waning immunity. Although recognition of adult pertussis has increased in tandem with a better understanding ofB. pertussispathogenesis, pertussis in neonates and adults can manifest with atypical clinical presentations. Such disease patterns make pertussis recognition difficult and lead to delays in treatment. Ongoing research using newer tools for molecular analysis holds promise for improved understanding of pertussis epidemiology, bacterial pathogenesis, bioinformatics, and immunology. Together, these advances provide a foundation for the development of new-generation diagnostics, therapeutics, and vaccines.

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“…We included the following potentially immunization-related characteristics in the survey: maternal race, marital status, maternal age, education level, employment status, monthly income, receipt of prenatal care, WIC participation, infant birth order, and usual clinical care site (i.e., hospital-affiliated site, private office or community clinic/health center, or none). 7,8,[27][28][29][30][31] We administered the short version of the Test of Functional Health Literacy in Adults (S-TOFHLA) to each mother. The S-TOFHLA is a wellvalidated measure of functional health literacy that uses specific health-related examples to assess reading comprehension.…”

Section: Data Sourcesmentioning

confidence: 99%

Do changes in socio-demographic characteristics impact up-to-date immunization status between 3 and 24 months of age? A prospective study among an inner-city birth cohort in the United States

Pati

Huang

Wong

et al. 2017

Human Vaccines & Immunotherapeutics

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Introduction: Low-income child populations remain under-vaccinated. Our objective was to determine differences in the relative importance of maternal health literacy and socio-demographic characteristics that often change during early childhood on up-to-date (UTD) immunization status among a low-income population. Methods: We performed secondary data analysis of a longitudinal prospective cohort study of 744 Medicaid-eligible mother-infant dyads recruited at the time of the infant's birth from an inner-city hospital in the United States and surveyed every 6 months for 24 months. Our primary outcome was infant UTD status at 24 months abstracted from a citywide registry. We assessed maternal health literacy with the Test of Functional Health Literacy in Adults (short version). We collected socio-demographic information via surveys at birth and every 6 months. We compared predictors of UTD status at 3, 7, and 24 months. Results: The cohort consisted of primarily African-American (81.5%) mothers with adequate health literacy (73.9%). Immunizations were UTD among 56.7% of infants at 24 months of age. Maternal health literacy was not a significant predictor of UTD immunization status. Instead, adjusted results showed that significant predictors of not-UTD status at 24 months were lack of a consistent health care location or "medical home" (OR 0.17, 95%CI 0.18-0.37), inadequate prenatal care (OR 0.48, 95%CI 0.25-0.95), and prior not-UTD status (OR 0.31,. Notably, all upper confidence limits are less than 1.0 for these variables. Health care location type (e.g., hospital-affiliate, community-based, none) was a significant predictor of vaccine status at age 3 months, 7 months, and 24 months. Conclusions: Investing in efforts to support early establishment of a medical home to obtain comprehensive coordinated preventive care, including providing recommended vaccines on schedule, is a prudent strategy to improve vaccination status at the population level.

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Factors Associated with Underimmunization at 3 Months of Age in Four Medically Underserved Areas

Cited by 58 publications

References 22 publications

Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

Determinants of Influenza Vaccination Among Young Children in an Inner-City Community

Pertussis: Microbiology, Disease, Treatment, and Prevention

Do changes in socio-demographic characteristics impact up-to-date immunization status between 3 and 24 months of age? A prospective study among an inner-city birth cohort in the United States

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