Immunization Levels Among Inner City Children Enrolled In Subsidized Childcare Just Over Half Of National Averages, USA

Main Category: Immune System / Vaccines
Also Included In: Pediatrics / Children's Health
Article Date: 09 May 2008 - 3:00 PST

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The Centers for Disease Control and Prevention (CDC) conduct the National Immunization Survey to track rates of recommended immunization around the country. Since 2006, up-to-date (UTD) immunization of 2 year olds has held steady at about 82% of children nationally. Even of 19-35 month olds living in households below the federal poverty level, 92% are UTD with the basic set of vaccinations, according to CDC data. However, scientists have long suspected that rates in the inner city may be a great deal lower, but have been unable to measure those rates with any precision due to such facts as families in the inner city being highly mobile, lacking telephones, and refusing to take part in surveys.

Dr. Quimby McCaskill, of the University of Florida College of Medicine in Jacksonville, and his colleagues, decided to investigate immunization levels in the inner city by mining a newly available source of data: subsidized daycare (SDC) records. Since welfare reform went into effect in 1996, enrollment in SDC has skyrocketed.

The research team identified 156 children, ages 0-60 months, in 14 inner-city child care centers enrolled in SDC and obtained demographic and immunization information. ZIP-code distribution of sample children was correlated with similar aged children from the 2000 Census (family incomes <150% of poverty). Confirming scientists' worst fears, only 44.2% of the children in the sample were UTD with immunization at 12 months (3 DTaP, 2 HIB, 2 IPV, 3 Hep B).

This work is important because of the extremely low rate of being UTD in the inner city population sampled, and also because (as McCaskill argues) the rise of SDCs since welfare reform has produced a reliable dataset for finally measuring inner city vaccination rates accurately. (As a telling and related fact, we should note that during a recent measles epidemic, 70% of the unvaccinated cases were among inner city children from low-income households.)

The new work appears in the current issue of the Journal of Health Care for the Poor and Underserved (JHCPU 19.2, released today.)

Journal for Health Care for the Poor and Underserved

JHCPU has as its goal the dissemination of information on the health of, and health care for, low- income and other medically underserved communities to health care practitioners, policy makers, and community leaders who are in a position to effect meaningful change. Issues dealt with include access to, quality of, and cost of health care. It is owned by and edited at Meharry Medical College and published by Johns Hopkins University Press. Its affiliated membership organization is the Assn. of Clinicians for the Underserved (ACU).

Meharry Medical College is the nation's largest private, independent historically black institution dedicated solely to educating minority and other health professionals. The College is particularly well known for its uniquely nurturing, highly effective educational programs; emerging preeminence in health disparities research; culturally sensitive, evidence-based health services; and significant contribution to the diversity of the nation's health professions workforce.

JHCPU submissions website

Factline: Tracking Health in Underserved Communities

J. of Health Care for the Poor and Underserved