title: Adult vaccination disparities among foreign-born populations in the U.S., 2012.
abstract: BACKGROUND
  Foreign-born persons are considered at higher risk of undervaccination and exposure to many vaccine-preventable diseases. Information on vaccination coverage among foreign-born populations is limited.
  
  
  OBJECTIVE
  To assess adult vaccination coverage disparities among foreign-born populations in the U.S.
  
  
  METHODS
  Data from the 2012 National Health Interview Survey were analyzed in 2013. For non-influenza vaccines, the weighted proportion vaccinated was calculated. For influenza vaccination, Kaplan-Meier survival analysis was used to assess coverage among individuals interviewed during September 2011-June 2012 and vaccinated in August 2011-May 2012.
  
  
  RESULTS
  Overall, unadjusted vaccination coverage among U.S.-born respondents was significantly higher than that of foreign-born respondents: influenza, age ≥18 years (40.4% vs 33.8%); pneumococcal polysaccharide vaccine (PPV), 18-64 years with high-risk conditions (20.8% vs 13.7%); PPV, ≥65 years (62.6% vs 40.5%); tetanus vaccination, ≥18 years (65.0% vs 50.6%); tetanus, diphtheria, and acellular pertussis (Tdap), ≥18 years (15.5% vs 9.3%); hepatitis B, 18-49 years (37.2% vs 28.4%); shingles, ≥60 years (21.3% vs 12.0%); and human papilloma virus (HPV), women 18-26 years (38.7% vs 14.7%). Among the foreign born, vaccination coverage was generally lower for non-U.S. citizens, recent immigrants, and those interviewed in a language other than English. Foreign-born individuals were less likely than U.S.-born people to be vaccinated for pneumococcal (≥65 years), tetanus, Tdap, and HPV (women) after adjusting for confounders.
  
  
  CONCLUSIONS
  Vaccination coverage is lower among foreign-born adults than those born in the U.S. It is important to consider foreign birth and immigration status when assessing vaccination disparities and planning interventions.
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia. Electronic address: lhp8@cdc.gov.
authors.forename: Peng-Jun
authors.initials: PJ
authors.lastname: Lu
authors.affiliation: Division of Global Migration and Quarantine, National Center for Emerging & Zoonotic Infectious Diseases, CDC, Atlanta, Georgia.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Rodriguez-Lainz
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia.
authors.forename: Alissa
authors.initials: A
authors.lastname: O'Halloran
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia.
authors.forename: Stacie
authors.initials: S
authors.lastname: Greby
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia.
authors.forename: Walter W
authors.initials: WW
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011314:Preventive Health Services / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*; D014777:Virus Diseases / Q000453:epidemiology / Q000517:prevention & control*