title: Vaccination Coverage Disparities Between Foreign-Born and U.S.-Born Children Aged 19-35 Months, United States, 2010-2012.
abstract: Healthy People 2020 targets high vaccination coverage among children. Although reductions in coverage disparities by race/ethnicity have been described, data by nativity are limited. The National Immunization Survey is a random-digit-dialed telephone survey that estimates vaccination coverage among U.S. children aged 19-35 months. We assessed coverage among 52,441 children from pooled 2010-2012 data for individual vaccines and the combined 4:3:1:3*:3:1:4 series (which includes ≥4 doses of diphtheria, tetanus, and acellular pertussis vaccine/diphtheria and tetanus toxoids vaccine/diphtheria, tetanus toxoids, and pertussis vaccine, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, ≥3 or ≥4 doses of Haemophilus influenzae type b vaccine (depending on product type of vaccine; denoted as 3* in the series name), ≥3 doses of hepatitis B vaccine, ≥1 dose of varicella vaccine, and ≥4 doses of pneumococcal conjugate vaccine). Coverage estimates controlling for sociodemographic factors and multivariable logistic regression modeling for 4:3:1:3*:3:1:4 series completion are presented. Significantly lower coverage among foreign-born children was detected for DTaP, hepatitis A, hepatitis B, Hib, pneumococcal conjugate, and rotavirus vaccines, and for the combined series. Series completion disparities persisted after control for demographic, access-to-care, poverty, and language effects. Substantial and potentially widening disparities in vaccination coverage exist among foreign-born children. Improved immunization strategies targeting this population and continued vaccination coverage monitoring by nativity are needed.
authors.affiliation: CDC/CSTE Applied Epidemiology Fellowship Program, Atlanta, GA, USA.|Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, 3851 Rosecrans St, Suite 715, San Diego, CA, 92110, USA.|County of San Diego Health and Human Services Agency, San Diego, CA, USA.
authors.forename: Aiden K
authors.initials: AK
authors.lastname: Varan
authors.affiliation: Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, 3851 Rosecrans St, Suite 715, San Diego, CA, 92110, USA. jqi3@cdc.gov.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Rodriguez-Lainz
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.
authors.forename: Holly A
authors.initials: HA
authors.lastname: Hill
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.
authors.forename: Laurie D
authors.initials: LD
authors.lastname: Elam-Evans
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Yankey
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
mesh_terms: D002675:Child, Preschool; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D007223:Infant; D012959:Socioeconomic Factors; D014481:United States; D000073887:Vaccination Coverage / Q000706:statistics & numerical data*
keywords: Disparities; Foreign-born children; Immunization; Vaccine coverage