Disparities in immunizations.

Abstract

Our analysis published in this issue of the Journal1 predicts that disparities in vaccination coverage between non-Hispanic Whites and both non-Hispanic Blacks and Hispanics will widen, and the gap between non-Hispanic Whites and Asians will narrow. That analysis is based on 6 years of data (1996–2001) from the National Immunization Survey (NIS). Since then, 2002 NIS data have become available. We used these data to reanalyze and update our analyses (Table 1 ▶). This reanalysis confirmed 2 predictions: that the disparity between non-Hispanic Whites and non-Hispanic Blacks is widening and that the disparity between non-Hispanic Whites and Asians is lessening. However, one prediction was not confirmed; that is, the predicted disparity between non-Hispanic Whites and Hispanics is not widening as much as it is remaining constant. TABLE 1— Comparisons, by Race, of 4:3:1:3:3 Coverage Among US Infants Aged 19–35 Months: 1996–2002 These findings raise concerns about our progress toward reducing, much less eliminating, racial/ethnic disparities in vaccine coverage; the coverage gap between non-Hispanic Whites and non-Hispanic Blacks is wide and becoming wider, and that the gap nonHispanic Whites and Hispanics remains approximately the same. Childhood immunization coverage has been considered one of the “success stories” in terms of reducing racial/ethnic disparities in health care. These findings raise even more concern about the state of other health care measures that have, historically, exhibited greater disparities than immunization, such as rates of infant mortality and low birthweight.2 Currently implemented strategies for reducing disparities are obviously not effective in all communities; more creative measures that extend beyond traditional efforts must be considered if we are to reduce disparities.3