Effect of vaccination coordinators on socioeconomic disparities in immunization among the 2006 Connecticut birth cohort

Am J Public Health. 2014 Jan;104(1):e74-81. doi: 10.2105/AJPH.2013.301418. Epub 2013 Nov 14.

Abstract

Objectives: We examined socioeconomic status (SES) disparities and the influence of state Immunization Action Plan-funded vaccination coordinators located in low-SES areas of Connecticut on childhood vaccination up-to-date (UTD) status at age 24 months.

Methods: We examined predictors of underimmunization among the 2006 birth cohort (n = 34,568) in the state's Immunization Information System, including individual demographic and SES data, census tract SES data, and residence in an area with a vaccination coordinator. We conducted multilevel logistic regression analyses.

Results: Overall, 81% of children were UTD. Differences by race/ethnicity and census tract SES were typically under 5%. Not being UTD at age 7 months was the strongest predictor of underimmunization at age 24 months. Among children who were not UTD at age 7 months, only Medicaid enrollment (adjusted odds ratio [AOR] = 0.6; 95% confidence interval [CI] = 0.5, 0.7) and residence in an area with a vaccination coordinator (AOR = 0.7; 95% CI = 0.6, 0.9) significantly decreased the odds of subsequent underimmunization.

Conclusions: SES disparities associated with underimmunization at age 24 months were limited. Efforts focused on vaccinating infants born in low SES circumstances can minimize disparities.

MeSH terms

  • Censuses
  • Connecticut
  • Ethnicity / statistics & numerical data
  • Female
  • Healthcare Disparities
  • Humans
  • Immunization Programs*
  • Infant
  • Male
  • Socioeconomic Factors
  • Vaccination / statistics & numerical data*
  • Workforce