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Timely Prenatal and Infant Pertussis Vaccine Uptake in an Integrated Health System
Tracy Becerra-Culqui1, Bradley Ackerson2,3, Hung Fu Tseng4,5
1Department of Occupational Therapy, California State University, Dominguez Hills, Carson, CA, USA.
Insights
Foreign-born Hispanic mothers show higher tetanus, diphtheria, and acellular pertussis (Tdap) vaccine uptake. Infants with Medicaid-insured mothers not enrolled in health plans may lack pertussis protection.
Area of Science:
- Public Health
- Immunization
- Health Disparities
Background:
- Hispanic infants experience a disproportionate burden of pertussis (whooping cough) infections.
- Pertussis vaccination is critical for infant protection against this potentially severe respiratory illness.
Purpose of the Study:
- To compare pertussis vaccine protection in infants born to US-born versus foreign-born Hispanic mothers.
- To identify factors influencing vaccine uptake and adherence in diverse maternal populations.
Main Methods:
- Retrospective cohort study analyzing data from infants up to 1 year of age.
- Included mothers with continuous health plan membership from 27 weeks gestation.
- Data collected from an integrated health care system in Southern California (2012-2017).
Main Results:
- Foreign-born Hispanic mothers demonstrated higher prenatal tetanus, diphtheria, acellular pertussis (Tdap) vaccine uptake compared to US-born white mothers.
- Infants of mothers with Medicaid insurance had low enrollment rates for the DTaP vaccine series (68.4%).
- Once initiated, foreign-born Hispanic mothers showed greater adherence to the infant vaccine series than US-born white mothers.
Conclusions:
- Disparities in vaccine uptake can be reduced within integrated health systems.
- Infants born to mothers with Medicaid insurance who are not enrolled in health plans post-birth are at risk of pertussis under-protection.
Background:
Hispanic infants bear the burden of pertussis infection. We examined pertussis protection from vaccination in infants with US-born and foreign-born Hispanic mothers.
Methods:
Retrospective cohort study of infants up to 1 year of age. Secondary data of mothers with continuous membership since the 27th week of pregnancy with infants born 1/1/2012-12/31/2017 in an integrated health care delivery organization, which broadly represent the Southern California population.
Results:
Foreign-born Hispanic mothers had higher prenatal tetanus, diphtheria, acellular pertussis (Tdap) uptake compared to US-born white mothers [adjusted risk ratio (aRR): 1.04, 95% confidence interval (CI): 1.03, 1.05]. Infants with mothers on Medicaid insurance disproportionately did not enroll in the health plan by the time they were eligible for their first dose of the DTaP vaccine (68.4%). Once initiating the infant vaccine series, foreign-born Hispanic mothers more likely adhered than US-born white mothers (aRR: 1.05, CI: 1.02, 1.08).
Discussion:
In an integrated health system, disparities in vaccine uptake can be minimized. Infants who are born to mothers with Medicaid insurance and are not enrolled in the health plan after birth may be under-protected from pertussis.
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