Effect of vaccination coordinators on socioeconomic disparities in immunization among the 2006 Connecticut birth cohort.
OBJECTIVE
We examined socioeconomic status (SES) disparities and the influence of state Immunization Action Plan-funded vaccination coordinators located in low-SES areas of Connecticut on childhood vaccination up-to-date (UTD) status at age 24 months.


METHODS
We examined predictors of underimmunization among the 2006 birth cohort (n = 34,568) in the state's Immunization Information System, including individual demographic and SES data, census tract SES data, and residence in an area with a vaccination coordinator. We conducted multilevel logistic regression analyses.


RESULTS
Overall, 81% of children were UTD. Differences by race/ethnicity and census tract SES were typically under 5%. Not being UTD at age 7 months was the strongest predictor of underimmunization at age 24 months. Among children who were not UTD at age 7 months, only Medicaid enrollment (adjusted odds ratio [AOR] = 0.6; 95% confidence interval [CI] = 0.5, 0.7) and residence in an area with a vaccination coordinator (AOR = 0.7; 95% CI = 0.6, 0.9) significantly decreased the odds of subsequent underimmunization.


CONCLUSIONS
SES disparities associated with underimmunization at age 24 months were limited. Efforts focused on vaccinating infants born in low SES circumstances can minimize disparities.
At the time of the study, Jessica A. Kattan was an Epidemic Intelligence Service Officer with the Centers for Disease Control and Prevention (CDC), assigned to the Infectious Diseases Section, Connecticut Department of Public Health, Hartford. Kathy S. Kudish is with the Immunization Program and Kristen Soto is with the Infectious Diseases Section, Connecticut Department of Public Health. Betsy L. Cadwell is with the Office of Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, GA. James L. Hadler is a consultant for the Connecticut Emerging Infections Program, New Haven.
Jessica A
JA
Kattan
Kathy S
KS
Kudish
Betsy L
BL
Cadwell
Kristen
K
Soto
James L
JL
Hadler
D019352:Censuses; D003237:Connecticut; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D008297:Male; D012959:Socioeconomic Factors; D014611:Vaccination / Q000706:statistics & numerical data*; D000078329:Workforce