Vaccination coverage for African American children in Los Angeles

Abstract

Purpose To assess the vaccination coverage and factors associated with vaccination for African American children 2 to 3 years old in Los Angeles County. Methods Two-stage cluster survey with probability proportionate to estimated size at the first stage, and simple random sample of children at the second stage. We collected data through interview. Vaccination coverage information was abstracted from the immunization record card (IRC) at home during interview or from clinic records. The participation was 78% of all eligible sampled children. The margin of error was 2% to 4%. Results Of the 362 sampled children, 58% were 2 years old and 51% were female. Of the parents, 26% did not have the IRC at home during the interview and 50% knew fewer than four vaccine-preventable diseases. Most children (88%) received their vaccine shots from pediatricians. Thirty percent of the children had no regular source of health care, 19% were never enrolled in the Women, Infants, and Children Program (WIC), and 55% had Medi-Cal health insurance. Vaccination coverage was more than 90% for the first two doses of diphtheria, tetanus toxoids, and pertussis (DTP) and poliovirus (Polio) vaccines and for the first dose of Haemophilus influenzae type b (Hib), hepatitis B (Hep B), and measles, mumps, and rubella (MMR) vaccines. However, only 74% (± 4%) of the children had received the combined series of 4:3:1 (4 DTP, 3 Polio, 1 MMR). This was further reduced to 67% (± 4%) for the combined series of 4:3:1:3:3 (4 DTP, 3 Polio, 1 MMR, 3 Hib, 3 Hep B) (fully vaccinated). More likely to be fully vaccinated were children who were immunized by a pediatrician (odds ratio OR = 2.0, 95% confidence interval CI = 1.0–3.9), whose parents had IRC at home during the interview (OR = 2.5, 95% CI = 1.4–4.5), and whose parents knew at least four vaccine-preventable diseases (OR = 1.5, 95% CI = 0.9–2.4). Conclusion Full vaccination coverage for the African American children in Los Angeles County is close to the national level for black children (68%) and lower than the level for Los Angeles County overall (76%). More vaccination services and outreach programs are needed to get children fully vaccinated.