Children and Adolescents Unvaccinated Against Measles: Geographic Clustering Parents Beliefs and Missed Opportunities.

Tuesday, 5th of April 2016 Print

Public Health Rep. 2015 Sep-Oct;130(5):485-504.

Children and Adolescents Unvaccinated Against Measles: Geographic Clustering Parents Beliefs and Missed Opportunities.

Smith PJ1 Marcuse EK2 Seward JF1 Zhao Z1 Orenstein WA3.

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Abstract

OBJECTIVE:

We evaluated the extent to which children and adolescents were not vaccinated against measles ("unvaccinated") clustering within U.S. counties and factors associated with unvaccination including parents vaccine-related beliefs and missed opportunities.

METHODS:

We analyzed data from the 2010-2013 National Immunization Survey (NIS) and NIS-Teen Survey of households with 19- to 35-month-old children and 13- to 17-year-old adolescents respectively. We used provider-reported vaccination histories to assess measles vaccination status.

RESULTS:

In 2013 7.5% of children and 4.5% of adolescents were unvaccinated against measles. Four-fifths (80.0%) of unvaccinated children lived in counties containing 41.9% of the nations children and 80.0% of unvaccinated adolescents lived in counties containing 30.4% of the nations adolescents. Multivariable statistical analyses found that 74.6% of children who were unvaccinated against measles missed being vaccinated for reasons other than parents negative vaccine-related beliefs and 89.6% could be deemed as having at least one missed opportunity for being vaccinated against measles because they were administered at least one dose of other recommended vaccines after 12 months of age. Among adolescents multivariable analyses found that only demographic factors not vaccine-related parental beliefs were independently associated with being unvaccinated.

CONCLUSIONS:

Reasons other than negative vaccine-related beliefs including missed opportunities accounted for the vast majority of unvaccinated children and adolescents.

 

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