Variation in vaccination coverage among children of Hispanic ancestry.
BACKGROUND
Estimated vaccination coverage of Hispanic children is consistently lower than that of white non-Hispanic children. "Hispanic ethnicity" defines a highly heterogeneous group of the U.S. population; however, vaccination coverage by ancestry group has not been studied. This study explores differences in vaccination coverage among Hispanic children by ancestry group.


METHODS
The National Immunization Survey (NIS) uses a random-digit-dial sample of telephone numbers in each state and in 28 urban areas. The NIS provides vaccination coverage information representative of all U.S. children aged 19 to 35 months. We pooled NIS data from 1996 through 1999 and selected Hispanic and white non-Hispanic children for analysis. We categorized Hispanic children into the following ancestry groups: Mexican, Central American, Puerto Rican, Cuban, South American, and Dominican. We used t tests to detect differences in coverage between children of Hispanic ancestry, by group, compared to white non-Hispanic children, by vaccine, and the vaccination series 4:3:1:3.


RESULTS
Estimated vaccination coverage with 4:3:1:3 was 80.1% (95% CI, 79.6-80.6) among white non-Hispanic children. Estimated coverage was lower among Puerto Rican (75.8%; 95% CI, 72.1-79.5), Cuban (73.1%; 95% CI, 65.1-81.1), Mexican (71.7%; 95% CI, 69.9-73.5), and Central American (68.7%; 95% CI, 62.0-75.4) children, and was higher among South American (82.0%; 95% CI, 75.5-88.5) and Dominican (82.2%; 95% CI, 75.5-88.5) children; however, these differences were only statistically significant for Puerto Rican, Mexican, and Central American children. Among children living in poverty, estimated coverage with 4:3:1:3 was lower among Mexican (68.0%; 95% CI, 65.1-70.9), Central American (69.7%; 95% CI, 59.8-79.6), and South American (69.0%; 95% CI, 50.9-87.1) children than among white non-Hispanic children (73.4%; 95% CI, 71.6-75.2); however, this difference was significant only among Mexican children. Coverage was similar or somewhat higher among Puerto Rican (72.9%; 95% CI, 65.7-80.1) and Dominican (80.2%; 95% CI, 68.5-91.9) children than white non-Hispanic children living below poverty.


CONCLUSIONS
Findings from the NIS strongly suggest that estimated vaccination coverage among children of Hispanic ancestry varies by group. Improved monitoring of vaccination coverage among Hispanics by community is necessary, and where undervaccination is identified, interventions should be matched to community needs.
Herrera
G A
GA
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. gah9@cdc.gov
Zhao
Z
Z
Klevens
R M
RM
D002675:Child, Preschool; D019538:Health Care Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D009313:National Health Programs; D010349:Patient Compliance / Q000208:ethnology; D012959:Socioeconomic Factors; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data