Elimination of measles and of disparities in measles childhood vaccine coverage among racial and ethnic minority populations in the United States.
The gap in measles vaccine coverage between white and nonwhite children was as large as 18% in 1970. During the measles epidemic of 1989-1991, attack rates among nonwhite children <5 years of age were 4- to 7-fold higher than rates among white children. Because of the epidemic and of the known disparity in vaccine coverage and risk of disease, a dual strategy to eliminate measles in the United States was implemented: universal interventions likely to reach the majority of children and targeted interventions more likely to reach nonwhite children. In 1992, the gap in coverage between white and nonwhite children was reduced to 6% (from 15% in 1985); the risk of disease among nonwhite children was narrowed to <or=4-fold the risk of white children. During the 1990s, further implementation of the dual strategy resulted in narrowing the gap in vaccine coverage to 2% and elimination of endemic disease in all racial and ethnic populations. This dual strategy deserves close scrutiny by health professionals and policy makers in devising programs to meet the Healthy People 2010 objectives for the elimination of other health disparities.
Hutchins
Sonja S
SS
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. ssh1@cdc.gov.
Jiles
Ruth
R
Bernier
Roger
R
D044383:Black People / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D015994:Incidence; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage*; D044469:Racial Groups / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
D008458:Measles Vaccine