scholarly journals 87. Impact of State of Residence on Adult Vaccination Uptake: A Multilevel Modeling Approach

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S175-S175
Author(s):  
Shannon Hunter ◽  
Diana Garbinsky ◽  
Elizabeth M La ◽  
Sara Poston ◽  
Cosmina Hogea
Keyword(s):  
Multilevel Modeling ◽  
Vaccination Coverage ◽  
Multilevel Models ◽  
State Level ◽  
Childhood Vaccination ◽  
Material Support ◽  
Adult Vaccination ◽  
Direct Compensation ◽  
Cluster Variation ◽  
Coverage Rates

Abstract Background Previous studies on adult vaccination coverage found inter-state variability that persists after adjusting for individual demographic factors. Assessing the impact of state-level factors may help improve uptake strategies. This study aimed to: • Update previous estimates of state-level, model-adjusted coverage rates for influenza; pneumococcal; tetanus, diphtheria, and acellular pertussis (Tdap); and herpes zoster (HZ) vaccines (individually and in compliance with all age-appropriate recommended vaccinations) • Evaluate effects of individual and state-level factors on adult vaccination coverage using a multilevel modeling framework. Methods Behavioral Risk Factor Surveillance System (BRFSS) survey data (2015–2017) were retrospectively analyzed. Multivariable logistic regression models estimated state vaccination coverage and compliance using predicted marginal proportions. BRFSS data were then combined with external state-level data to estimate multilevel models evaluating effects of state-level factors on coverage. Weighted odds ratios and measures of cluster variation were estimated. Results Adult vaccination coverage and compliance varied by state, even after adjusting for individual characteristics, with coverage ranging as follows: • Influenza (2017): 35.1–48.1% • Pneumococcal (2017): 68.2–80.8% • Tdap (2016): 21.9–46.5% • HZ (2017): 30.5–50.9% Few state-level variables were retained in final multilevel models, and measures of cluster variation suggested substantial residual variation unexplained by individual and state-level variables. Key state-level variables positively associated with vaccination included health insurance coverage rates (influenza/HZ), pharmacists’ vaccination authority (HZ), presence of childhood vaccination exemptions (pneumococcal/Tdap), and adult immunization information system participation (Tdap/HZ). Conclusion Adult vaccination coverage and compliance continue to show substantial variation by state even after adjusting for individual and state-level characteristics associated with vaccination. Further research is needed to assess additional state or local factors impacting vaccination disparities. Funding GlaxoSmithKline Biologicals SA (study identifier: HO-18-19794) Disclosures Shannon Hunter, MS, GSK (Other Financial or Material Support, Ms. Hunter is an employee of RTI Health Solutions, who received consultancy fees from GSK for conduct of the study. Ms. Hunter received no direct compensation from the Sponsor.) Diana Garbinsky, MS, GSK (Other Financial or Material Support, The study was conducted by RTI Health Solutions, which received consultancy fees from GSK. I am a salaried employee at RTI Health Solutions and received no direct compensation from GSK for the conduct of this study..) Elizabeth M. La, PhD, RTI Health Solutions (Employee) Sara Poston, PharmD, The GlaxoSmithKline group of companies (Employee, Shareholder) Cosmina Hogea, PhD, GlaxoSmithKline (Employee, Shareholder)

scholarly journals The knowledge, attitudes and beliefs of midwives on the vaccination coverage rates in Perth’s Aboriginal children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca Carman ◽  
Lesley Andrew ◽  
Amanda Devine
Keyword(s):  
Hospital Discharge ◽  
Vaccination Coverage ◽  
Target Population ◽  
Childhood Vaccination ◽  
Attitudes And Beliefs ◽  
Exact Test ◽  
Maternity Hospitals ◽  
Childhood Vaccines ◽  
Coverage Rates ◽  
Aboriginal Children

Abstract Background Midwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children. Methods A purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory of Planned Behavior were used to frame the questionnaire to enable the barriers to greater vaccination coverage to be identified and behaviourally situated. Descriptive statistics described the demographics of the study sample. Chi-square and the Fisher’s exact test were used to identify associations between midwife characteristics and awareness of the coverage rates. Significance was set at α = 0.05. Results Of the 58 midwives who completed the study questionnaire, 77.2% were unaware of the sub-optimal vaccination coverage in Perth’s Aboriginal children. Level of education (p = 0.53) and years worked as a practising midwife (p = 0.47) were not found to be associated with an awareness of the coverage rates. Approximately, 50% of midwives reported some concern over the efficacy of childhood vaccines, 44.4% did not feel confident with their knowledge of vaccines, while 33.3% do not routinely discuss childhood vaccinations with parents prior to hospital discharge. Conclusions Key findings in the study identified that a range of educational, leadership and system-based issues are affecting midwives’ capacity to play a more substantial role in influencing vaccination coverage in Perth’s Aboriginal children.

scholarly journals Analysis of State-Specific Differences in Childhood Vaccination Coverage in Rural India

Vaccines ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 24 ◽  
Author(s):  
Nijika Shrivastwa ◽  
Abram Wagner ◽  
Matthew Boulton
Keyword(s):  
Vaccination Coverage ◽  
State Level ◽  
Childhood Vaccination ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Institutional Settings ◽  
Childhood Immunizations ◽  
Indian Census ◽  
Facility Survey

There is little research on state-level differences in child health outcomes in India. The aim of this study was to identify state-level characteristics that relate to childhood immunizations. Most state-level characteristics came from the 2011 Indian Census. Individual-level data and other state-level characteristics were obtained from the 2007–2008 District Level Household and Facility Survey. Predictors of full vaccination were assessed with logistic regression models. Among 86,882 children 12–36 months, 53.2% were fully vaccinated. Children living in bigger households (≥7 members), born in non-institutional settings, and female had lower odds of complete vaccination. Individuals living in states in the mid-range of poverty had lower odds of full vaccination compared to those in lower or higher poverty states (3rd vs. 1st quintile: odds ratio [OR]: 0.36, 95% confidence interval [CI]: 0.30, 0.42). Greater average population per primary health center was associated with decreased odds of full vaccination (5th vs. 1st quintile: OR: 0.37, 95% CI: 0.30, 0.47). Vaccination coverage in India can be explained by a complex interplay of individual- and state-level factors. Solutions to increasing vaccination must be multisectoral and acknowledge the cultural and socio-economic diversity that influences an individual child’s vaccination coverage along with within-state disparities.

scholarly journals Inequities in Childhood Vaccination Coverage in Zhejiang, Province: Evidence from a Decomposition Analysis on Two-Round Surveys

2018 ◽  
Vol 15 (9) ◽  
pp. 2000 ◽  
Author(s):  
Yu Hu ◽  
Hui Liang ◽  
Ying Wang ◽  
Yaping Chen
Keyword(s):  
Risk Factors ◽  
Vaccination Coverage ◽  
Maternal Employment ◽  
Decomposition Analysis ◽  
Health Spending ◽  
Zhejiang Province ◽  
Childhood Vaccination ◽  
Decomposition Approach ◽  
Mother’S Age ◽  
Coverage Rates

Objective: The objectives of this study were to determine the degree and risk factors of the inequity in the childhood coverage of full primary immunization (FPI) in Zhejiang province. Method: We used data from two rounds of vaccination coverage surveys among children aged 24–35 months conducted in 2014 and 2017, respectively. The household income per month was used as an index of socioeconomic status for the inequality analysis. The concentration index (CI) was used to quantify the degree of inequality, and the decomposition approach was applied to quantify the contributions from demographic factors to inequality in the coverage of FPI. Results: The coverage rates of FPI were 80.6%, with a CI value of 0.12028 for the 2014 survey, while the coverage rates of FPI were 85.2%, with a CI value of 0.10129 for the 2017 survey. The results of decomposition analysis suggested that 68.2% and 67.1% of the socioeconomic inequality in the coverage of FPI could be explained by the mother’s education level for the 2014 and 2017 survey, respectively. Other risk factors including birth order, ethnic group, mother’s age, maternal employment status, residence, immigration status, GDP per-capita, and the percentage of the total health spending allocated to public health could also explain this inequality. Conclusion: The socioeconomic inequity in the coverage of FPI still remained, although this gap was reduced between 2014 and 2017. Policy recommendations for health interventions on reducing the inequality in the coverage of FPI should be focused on eliminating poverty and women’s illiteracy.

Childhood Vaccination Coverage Rates Among Military Dependents in the United States

PEDIATRICS ◽  
2015 ◽  
Vol 135 (5) ◽  
pp. e1148-e1156 ◽  
Author(s):  
A. C. Dunn ◽  
C. L. Black ◽  
J. Arnold ◽  
S. Brodine ◽  
J. Waalen ◽  
...  
Keyword(s):  
United States ◽  
Vaccination Coverage ◽  
The United States ◽  
Childhood Vaccination ◽  
Military Dependents ◽  
Coverage Rates

scholarly journals Childhood vaccination coverage in Australia: an equity perspective

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arzu Arat ◽  
Hannah C. Moore ◽  
Sharon Goldfeld ◽  
Viveca Östberg ◽  
Vicky Sheppeard ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Economic Status ◽  
Childhood Vaccination ◽  
High Coverage ◽  
Socio Economic Status ◽  
Policy Interventions ◽  
South Wales ◽  
Social Inequities ◽  
Future Policy ◽  
Aboriginal Children

Abstract Background This study describes trends in social inequities in first dose measles-mumps-rubella (MMR1) vaccination coverage in Western Australia (WA) and New South Wales (NSW). Using probabilistically-linked administrative data for 1.2 million children born between 2002 and 2011, we compared levels and trends in MMR1 vaccination coverage measured at age 24 months by maternal country of birth, Aboriginal status, maternal age at delivery, socio-economic status, and remoteness in two states. Results Vaccination coverage was 3–4% points lower among children of mothers who gave birth before the age of 20 years, mothers born overseas, mothers with an Aboriginal background, and parents with a low socio-economic status compared to children that did not belong to these social groups. In both states, between 2007 and 2011 there was a decline of 2.1% points in MMR1 vaccination coverage for children whose mothers were born overseas. In 2011, WA had lower coverage among the Aboriginal population (89.5%) and children of young mothers (89.3%) compared to NSW (92.2 and 92.1% respectively). Conclusion Despite overall high coverage of MMR1 vaccination, coverage inequalities increased especially for children of mothers born overseas. Strategic immunisation plans and policy interventions are important for equitable vaccination levels. Future policy should target children of mothers born overseas and Aboriginal children.

scholarly journals Determining Accurate Vaccination Coverage Rates for Adolescents: The National Immunization Survey-Teen 2006

2009 ◽  
Vol 124 (5) ◽  
pp. 642-651 ◽  
Author(s):  
Nidhi Jain ◽  
James A. Singleton ◽  
Margrethe Montgomery ◽  
Benjamin Skalland
Keyword(s):  
Vaccination Coverage ◽  
National Level ◽  
National Sample ◽  
Two Phase ◽  
National Immunization ◽  
Level Data ◽  
Control And Prevention ◽  
Coverage Rates ◽  
First Time ◽  
National Immunization Survey

Since 1994, the Centers for Disease Control and Prevention has funded the National Immunization Survey (NIS), a large telephone survey used to estimate vaccination coverage of U.S. children aged 19–35 months. The NIS is a two-phase survey that obtains vaccination receipt information from a random-digit-dialed survey, designed to identify households with eligible children, followed by a provider record check, which obtains provider-reported vaccination histories for eligible children. In 2006, the survey was expanded for the first time to include a national sample of adolescents aged 13–17 years, called the NIS-Teen. This article summarizes the methodology used in the NIS-Teen. In 2008, the NIS-Teen was expanded to collect state-specific and national-level data to determine vaccination coverage estimates. This survey provides valuable information to guide immunization programs for adolescents.

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