Preventable Disease, the Case of Colorado: School District Demographics and Childhood Immunizations

Overview

Journal Vaccines (Basel)

Date 2022 Oct 27

PMID 36298445

Authors

Katherine Nicolich

Jacob Gerken

Blaire Mallahan

David W Ross

Isain Zapata

Affiliations

Soon will be listed here.

Abstract

The objective of this study was to evaluate the impact of selected sociodemographic factors on childhood vaccination hesitancy and to define their role according to specific exemptions. This population-based cohort study utilized vaccination rate and sociodemographic data from 1st to 12th grade from 2017 to 2021 for all school districts in Colorado. Data included immunization status and exemptions for each vaccine, race, ethnicity, and free and reduced meal status. Data were evaluated through dimensional analysis and Generalized Linear Mixed Models. School districts with a higher representation of White students had lower immunization rates and use more personal exemptions while school districts with larger Hispanic populations and higher proportions of free and reduced lunches had higher vaccination rates and used more religious exemptions. Black and Pacific Islander populations had higher rates of incomplete vaccination records while Asian American population displayed increased vaccination compliance. Colorado is a robust example of how socioeconomic and cultural differences are important factors with a direct influence on vaccination rates. Future childhood vaccination campaigns and legislation should consider complex socioeconomic and cultural factors.

References

Shui I, Weintraub E, Gust D . Parents concerned about vaccine safety: Differences in race/ethnicity and attitudes. Am J Prev Med. 2006; 31(3):244-51. DOI: 10.1016/j.amepre.2006.04.006. View

Blank P, Schwenkglenks M, Szucs T . Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. J Infect. 2009; 58(6):446-58. DOI: 10.1016/j.jinf.2009.04.001. View

Dudley M, Limaye R, Salmon D, Omer S, OLeary S, Ellingson M . Racial/Ethnic Disparities in Maternal Vaccine Knowledge, Attitudes, and Intentions. Public Health Rep. 2021; 136(6):699-709. PMC: 8579395. DOI: 10.1177/0033354920974660. View

Gilkey M, McRee A, Brewer N . Forgone vaccination during childhood and adolescence: findings of a statewide survey of parents. Prev Med. 2013; 56(3-4):202-6. PMC: 3582706. DOI: 10.1016/j.ypmed.2012.12.019. View

Hardt K, Schmidt-Ott R, Glismann S, Adegbola R, Meurice F . Sustaining Vaccine Confidence in the 21st Century. Vaccines (Basel). 2015; 1(3):204-24. PMC: 4494231. DOI: 10.3390/vaccines1030204. View

Larson H, Jarrett C, Eckersberger E, Smith D, Paterson P . Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine. 2014; 32(19):2150-9. DOI: 10.1016/j.vaccine.2014.01.081. View

Freed G, Clark S, Butchart A, Singer D, Davis M . Parental vaccine safety concerns in 2009. Pediatrics. 2010; 125(4):654-9. DOI: 10.1542/peds.2009-1962. View

Kempe A, Saville A, Albertin C, Zimet G, Breck A, Helmkamp L . Parental Hesitancy About Routine Childhood and Influenza Vaccinations: A National Survey. Pediatrics. 2020; 146(1). PMC: 7329256. DOI: 10.1542/peds.2019-3852. View

Patel Murthy B, Zell E, Kirtland K, Jones-Jack N, Harris L, Sprague C . Impact of the COVID-19 Pandemic on Administration of Selected Routine Childhood and Adolescent Vaccinations - 10 U.S. Jurisdictions, March-September 2020. MMWR Morb Mortal Wkly Rep. 2021; 70(23):840-845. PMC: 8191867. DOI: 10.15585/mmwr.mm7023a2. View

10.

Omer S, Porter R, Allen K, Salmon D, Bednarczyk R . Trends in Kindergarten Rates of Vaccine Exemption and State-Level Policy, 2011-2016. Open Forum Infect Dis. 2018; 5(2):ofx244. PMC: 5798011. DOI: 10.1093/ofid/ofx244. View

11.

Bianco A, Mascaro V, Zucco R, Pavia M . Parent perspectives on childhood vaccination: How to deal with vaccine hesitancy and refusal?. Vaccine. 2019; 37(7):984-990. DOI: 10.1016/j.vaccine.2018.12.062. View

12.

Smith P, Humiston S, Marcuse E, Zhao Z, Dorell C, Howes C . Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the Health Belief Model. Public Health Rep. 2011; 126 Suppl 2:135-46. PMC: 3113438. DOI: 10.1177/00333549111260S215. View

13.

Torun S, Bakirci N . Vaccination coverage and reasons for non-vaccination in a district of Istanbul. BMC Public Health. 2006; 6:125. PMC: 1464125. DOI: 10.1186/1471-2458-6-125. View

14.

OLeary S, Trefren L, Roth H, Moss A, Severson R, Kempe A . Number of Childhood and Adolescent Vaccinations Administered Before and After the COVID-19 Outbreak in Colorado. JAMA Pediatr. 2020; 175(3):305-307. PMC: 7921904. DOI: 10.1001/jamapediatrics.2020.4733. View

15.

Aw J, Seng J, Seah S, Low L . COVID-19 Vaccine Hesitancy-A Scoping Review of Literature in High-Income Countries. Vaccines (Basel). 2021; 9(8). PMC: 8402587. DOI: 10.3390/vaccines9080900. View

16.

Smith P, Chu S, Barker L . Children who have received no vaccines: who are they and where do they live?. Pediatrics. 2004; 114(1):187-95. DOI: 10.1542/peds.114.1.187. View

17.

DeSilva M, Haapala J, Vazquez-Benitez G, Daley M, Nordin J, Klein N . Association of the COVID-19 Pandemic With Routine Childhood Vaccination Rates and Proportion Up to Date With Vaccinations Across 8 US Health Systems in the Vaccine Safety Datalink. JAMA Pediatr. 2021; 176(1):68-77. PMC: 8498937. DOI: 10.1001/jamapediatrics.2021.4251. View

18.

Gostin L, DeAngelis C . Mandatory HPV vaccination: public health vs private wealth. JAMA. 2007; 297(17):1921-3. DOI: 10.1001/jama.297.17.1921. View

19.

Attwell K, Navin M, Lopalco P, Jestin C, Reiter S, Omer S . Recent vaccine mandates in the United States, Europe and Australia: A comparative study. Vaccine. 2018; 36(48):7377-7384. DOI: 10.1016/j.vaccine.2018.10.019. View

20.

Slotte P, Karlsson L, Soveri A . Attitudes towards mandatory vaccination and sanctions for vaccination refusal. Vaccine. 2022; 40(51):7378-7388. DOI: 10.1016/j.vaccine.2022.05.069. View