Infectious Disease
The association between county-level social vulnerability and childhood vaccination rates at time of primary school entry James Buckley* James Buckley Patrick Maloney Alison Keyser-Metobo Derek Julian
Background: We examined the association between county-level social vulnerability and vaccination completion rates among Nebraska children entering primary school during the 2021-2022 academic year.
Methods: Data on county-level vaccination rates were drawn from the Nebraska State Immunization Information System. Rates were assessed for the Measles, Mumps, and Rubella (MMR), Polio, Varicella, Diphtheria, Tetanus, and Pertussis (DTaP), and the Hepatitis B (HepB) vaccines. A combined rate for all vaccines was also assessed. Social Vulnerability Index (SVI) scores were drawn from the CDC/ATSDR Geospatial Research, Analysis & Services Program. We assessed the relationship between vaccine uptake and social vulnerability using multivariate Poisson regression modeling.
Results: The mean childhood county-level vaccine rate was 69.14% for MMR, 68.84% for Polio, 68.81% for Varicella, 61.14% for DTaP, 82.84% for HepB and 57.89% overall. Socioeconomic Status (Theme 1) was associated with decreased rates of combined vaccination completion [0.85(0.74,0.97)]. Household Characteristics (Theme 2) was associated with increased rates of combined vaccination completion [1.41(1.30,1.53)] and each individual vaccine. Racial/Ethnic Minority Status was associated with decreased rates for combined vaccine completion [0.77 (0.71,0.85)] and for each individual vaccine. Housing Type/Transportation (Theme 4) was not associated with the rate of combined vaccine completion [1.06(0.94,1.20)] but was associated with increased rates of vaccination for Polio [1.24(1.11,1.39)], HepB [1.11 (1.00,1.23)], and DTaP [1.14(1.01,1.28)].
Conclusion: SVI is a critical tool for evaluating the relationship between specific aspects of social vulnerability and childhood vaccination uptake and can be used to inform and evaluate future interventions. Additional research should be conducted to evaluate the underlying causes of decreased vaccination uptake among racial and ethnic minorities.
