Vaccinations will prevent nearly 325 million cases of disease among U.S. children born between 1994 and 2013. Yet not all children will receive all of the vaccines recommended by Healthy People 2020, a set of goals and objectives with 10-year targets for national health promotion and disease prevention. As the Centers for Disease Control and Prevention (CDC) explains in a recent Morbidity and Mortality Weekly Report (MMWR), geographic location and household income are related to vaccination rates.
State and local jurisdictions require children to receive vaccinations before starting school, but that doesn’t mean kids in New York have the same vaccine-specific immunization rates as kids in New Mexico. There are significant variations in coverage by state, including for HepB birth dose, HepA, and rotavirus. There are also geographic differences in incidences of diseases, as the 2015 outbreak of measles in California shows.
Geography matters, but household income matters even more.
Compared to children living at or above the poverty level, children from households with incomes below the federal poverty level had lower estimated coverage for almost all vaccinations. Lack of transportation and difficulty getting time off from work are just some of the challenges that poorer families might face, the MMWR speculates. The Vaccines for Children program has helped to eliminate financial obstacles, but families who live below the federal poverty level may need additional assistance paying for immunizations.
Vaccinations that are administered in a series of doses over a period of time can be especially challenging. For example, infants should receive their first rotavirus vaccination at age 2 months and a final dose before 8 months of age. Yet children living below the poverty level had a rotavirus coverage rate that was 14.1% lower than that of children living at or above the poverty level. Other vaccines, such as Hib and DTaP, are also administered in multiple doses over a period time.
Healthcare providers need to be aware of differences in vaccination rates among children from different socioeconomic backgrounds. As the MMWR explains, “ensuring that providers are fully aware of appropriate catch-up vaccination practices could be an important strategy for achieving full coverage with these vaccines, as could encouraging use of combination vaccines.”
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