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Vaccination Trends and Family-Level Characteristics Associated With Incomplete or Delayed Childhood Immunizations:
Lauren M Zell-Baran1,2, Anne P Starling1,3,4, Deborah H Glueck3,5
1Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Insights
Childhood immunization schedule adherence is low in Colorado, with factors like parental education and household income influencing completion rates. Identifying at-risk families can improve vaccination coverage.
Area of Science:
- Pediatric Health
- Public Health
- Epidemiology
Background:
- Childhood immunizations are crucial for preventing infectious diseases.
- Adherence to recommended vaccination schedules is essential for community immunity.
- Understanding factors influencing immunization adherence is vital for public health initiatives.
Purpose of the Study:
- To assess family-level factors associated with adherence to childhood immunization schedules.
- To identify predictors of vaccination schedule completion in young children.
Main Methods:
- Prospective cohort study of 1,410 pregnant women in Denver, Colorado (2009-2014).
- Analysis of vaccination data for children aged 0-6 years.
- Logistic regression used to compare family-level factors influencing vaccine schedule adherence.
Main Results:
- Only 61.8% of children completed the full vaccination series, below national goals.
- Factors associated with non-adherence included in-utero smoke exposure, single-parent households, non-White ethnicity, mothers not working outside the home, and lower household income.
- Higher maternal education and older parental age were associated with increased likelihood of completing the vaccination series.
Conclusions:
- Specific family-level factors are significantly associated with childhood immunization schedule adherence.
- Findings can inform targeted interventions to improve vaccination rates in at-risk populations.
- Addressing barriers related to socioeconomic status and parental factors may reduce immunization hesitancy and increase access.
Purpose:
Assess family-level factors associated with childhood immunization schedule adherence.
Design:
Prospective cohort; Setting; The Healthy Start study enrolled 1,410 pregnant women in Denver, Colorado 2009-2014.
Subjects:
Children with available vaccination data in medical records (0-6 years old).
Measures:
Vaccine schedule completion and compliance.
Analysis:
Logistic regression comparing family-level factors that differ based on vaccine schedule adherence.
Results:
Most immunizations required in Colorado for school entry were below national completion goals with 61.8% of participants (n = 532/861) completing the full vaccination series. Most participants received the first dose of individual vaccines on time (73.5% - 90.7%), but fewer received all doses on time (21.0% - 39.5%). Factors associated with not completing the vaccination series (OR [95% CI]) included: in-utero exposure to cigarette smoke (1.97 [1.41, 2.75]), single parent household (1.70 [1.21, 2.38]), children identified as non-White (Hispanic 1.40 [1.01, 1.94]; Black 1.88 [1.24, 2.85]; Other 2.17 [1.34, 3.49]), mothers not working outside the home (1.98 [1.46, 2.67]), and household income <$70,000 per year (<$40,000 1.93 [1.35, 2.75]; $40,000-$70,000 1.64 [1.09, 2.46]). Conversely, families with more educated mothers (0.47 [0.29, 0.76]) and older parents (0.97 [0.94, 0.99]) were significantly more likely to complete the series.
Conclusions:
These findings may help identify groups at risk of immunization schedule non-adherence and may be used to target education/advocacy campaigns to reduce hesitancy and increase access in these populations.
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