title: Childhood vaccination coverage rates among military dependents in the United States.
abstract: OBJECTIVE
  The Military Health System provides universal coverage of all recommended childhood vaccinations. Few studies have examined the effect that being insured by the Military Health System has on childhood vaccination coverage. The purpose of this study was to compare the coverage of the universally recommended vaccines among military dependents versus other insured and uninsured children using a nationwide sample of children.
  
  
  METHODS
  The National Immunization Survey is a multistage, random-digit dialing survey designed to measure vaccination coverage estimates of US children aged 19 to 35 months old. Data from 2007 through 2012 were combined to permit comparison of vaccination coverage among military dependent and all other children.
  
  
  RESULTS
  Among military dependents, 28.0% of children aged 19 to 35 months were not up to date on the 4:3:1:3:3:1 vaccination series excluding Haemophilus influenzae type b vaccine compared with 21.1% of all other children (odds ratio: 1.4; 95% confidence interval: 1.2-1.6). After controlling for sociodemographic characteristics, compared with all other US children, military dependent children were more likely to be incompletely vaccinated (odds ratio: 1.3; 95% confidence interval: 1.1-1.5).
  
  
  CONCLUSIONS
  Lower vaccination coverage rates among US military dependent children might be due to this population being highly mobile. However, the lack of a military-wide childhood immunization registry and incomplete documentation of vaccinations could contribute to the lower vaccination coverage rates seen in this study. These results suggest the need for further investigation to evaluate vaccination coverage of children with complete ascertainment of vaccination history, and if lower immunization rates are verified, assessment of reasons for lower vaccination coverage rates among military dependent children.
authors: Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California; Graduate School of Public Health, San Diego State University, San Diego, California; acdunn@cdc.gov.
authors: Angela C
authors: AC
authors: Dunn
authors: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, Georgia; and.
authors: Carla L
authors: CL
authors: Black
authors: Department of Pediatrics, Naval Medical Center San Diego, San Diego, California.
authors: John
authors: J
authors: Arnold
authors: Graduate School of Public Health, San Diego State University, San Diego, California;
authors: Stephanie
authors: S
authors: Brodine
authors: Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California; Graduate School of Public Health, San Diego State University, San Diego, California;
authors: Jill
authors: J
authors: Waalen
authors: Graduate School of Public Health, San Diego State University, San Diego, California;
authors: Nancy
authors: N
authors: Binkin
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008889:Military Personnel; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*
keywords: children; health insurance; immunization; infant; military; survey; vaccine