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The impact of social vulnerability on primary vaccine coverage in children with sickle cell disease

Jiajing Scarlette Shi1,2,3, Erin LaFon4, Ankit Sutaria4

  • 1Georgia Health Policy Center, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, United States.

Frontiers in Public Health
|January 21, 2026
PubMed

Insights

Social vulnerability impacts vaccine coverage in children with sickle cell disease (SCD). Targeted outreach in high-vulnerability areas can improve up-to-date (UTD) vaccination rates for essential pediatric vaccines.

Area of Science:

  • Pediatric Health
  • Public Health
  • Immunology

Background:

  • Children with sickle cell disease (SCD) require timely vaccinations for optimal health outcomes.
  • Social vulnerability is increasingly recognized as a barrier to healthcare access and adherence, including immunization.
  • Understanding the interplay between social vulnerability and vaccine coverage in pediatric SCD populations is crucial for public health interventions.

Purpose of the Study:

  • To examine the association between social vulnerability and up-to-date (UTD) primary vaccine coverage among children with SCD.
  • To identify specific social vulnerability factors that influence vaccine completion rates in this population.

Main Methods:

  • Retrospective cohort study of 1,337 children with SCD born in Georgia (2008-2019).
  • Immunization data from state registry linked to Social Vulnerability Index (SVI) scores based on birth address.
  • Multivariable logistic regression analysis to assess the relationship between SVI scores and vaccine completion by 24 months.

Main Results:

  • 58% of children with SCD achieved UTD primary vaccine series by 24 months.
  • 37% resided in areas with high SVI.
  • Socioeconomic vulnerability was associated with higher odds of UTD coverage for poliovirus, MMR, Hib, and Hepatitis B vaccines.

Conclusions:

  • Children with SCD are disproportionately affected by social vulnerability, impacting their vaccination status.
  • The Social Vulnerability Index can guide targeted vaccine outreach strategies, particularly in areas with high housing and transportation vulnerability.
  • Prioritizing multi-dose and varicella vaccines may be beneficial in vulnerable populations.
Abstract

Keywords:
immunizationpediatricsickle cell diseasesocioeconomic characteristicsvulnerability

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