Background Black children are less likely to be up-to-date on immunizations and also have decreased access to care.
Objective Does reduced number of visits for immunizations by black children explain reduced immunization rates when compared to all other races?
Methods Data from the 2002 National Immunization Survey (NIS), a nationally representative sample survey, were used to examine visits for vaccination of children between 19-35 months old. Up-to-date (UTD) immunization was defined as 4 DTaP: 3 HepB: 1 MMR: 3 Hib: 3 IPV. The predictors were total number of immunization visits dates for these vaccines and race/ethnicity. Confounder variables included poverty status and age at first DTaP. Analyses accounted for the complex sampling design. We performed means, t-test, linear and logistic regression analyses utilizing SAS 9.0 and Stata 8.0.
Results The overall mean number of vaccination visits in 2002 was 5.89 (95% CI 5.85, 5.93). At 6.02 visits (5.97, 6.06), white children had more visits than black (5.61; 5.51, 5.71) or Hispanic children (5.73; 5.64, 5.82). Among children who were UTD, white children had significantly more visits at 6.35 (6.31, 6.39) compared to black (6.11; 6.02, 6.21) or Hispanic (6.12; 6.05, 6.20) children. Black children had more vaccines per visit than white children. In multivariable models, race and number of visits were significant independent predictors of being UTD even when controlling for poverty status and age at first DTaP.
Conclusion Minority children had fewer visits for immunizations and more vaccines per visit even when fully immunized than white children. Black children are better immunized than would be expected for the number of immunization visits. Access to care is a critical component of ensuring immunization as well as other critical aspects of care for minority children.