Factors Related to Pertussis and Tetanus Vaccination Status Among Foreign-Born Adults Living in the United States

Abstract

Pertussis is a common vaccine-preventable disease (VPD) worldwide. Its reported incidence has increased steadily in the United States, where it is endemic. Tetanus is a rare but potentially fatal VPD. Foreign-born adults have lower tetanus–diphtheria–pertussis (Tdap) and tetanus–diphtheria (Td) vaccination coverage than do U.S.-born adults. We studied the association of migration-related, socio-demographic, and access-to-care factors with Tdap and Td vaccination among foreign-born adults living in the United States. The 2012 and 2013 National Health Interview Survey data for foreign-born respondents were analyzed. Multivariable logistic regression was conducted to calculate prevalence ratios and 95% confidence intervals, and to identify variables independently associated with Tdap and Td vaccination among foreign-born adults. Tdap and Td vaccination status was available for 9316 and 12,363 individuals, respectively. Overall vaccination coverage was 9.1% for Tdap and 49.8% for Td. Younger age, higher education, having private health insurance (vs. public insurance or uninsured), having visited a doctor in the previous year, and region of residence were independently associated with Tdap and Td vaccination. Among those reporting a doctor visit, two-thirds had not received Tdap. This study provides further evidence of the need to enhance access to health care and immunization services and reduce missed opportunities for Tdap and Td vaccination for foreign-born adults in the United States. These findings apply to all foreign-born, irrespective of their birthplace, citizenship, language and years of residence in the United States. Addressing vaccination disparities among the foreign-born will help achieve national vaccination goals and protect all communities in the United States.

An analysis of factors associated with influenza, pneumoccocal, Tdap, and herpes zoster vaccine uptake in the US adult population and corresponding inter-state variability

“… 14–17 Further, health status, presence of chronic conditions, and receiving advice from health care professionals are documented factors associated with vaccine uptake. 17 Overall, results from our multivariable regression models were generally consistent with several previous studies that have reported associations between demographic characteristics, health status, and/or health care utilization behaviors and receipt of influenza vaccination, 14–17 Tdap vaccination, 15,18 HZ vaccination, 9,19 or pneumococcal vaccination. 20 …”

Determinants of Tetanus Vaccination among Adult Immigrants: Findings from the Portuguese National Health Survey 2014

“…In our study, we observed that self-reported tetanus vaccination coverage decreased with age, with older immigrants (≥65 years of age) reporting a tetanus vaccination coverage of only 58.1% (95% CI: 45.0–70.1). This finding is in line with other studies conducted among immigrants [9,18]. As this decrease with age was also observed among Portuguese natives (data not shown), it would be beneficial to carry out a vaccination catch-up campaign targeting older age groups, regardless of an individuals’ immigration status.…”

“…Adult immigrants with the highest household income per adult were less likely to report tetanus vaccination when compared to those with the lowest income. This finding is contrary to other studies conducted among adult immigrants [18], and in the general adult population [13]. However, this is in line with our belief that financial barriers are not a factor associated with vaccination uptake because vaccines included in the Portuguese NIP are free of charge.…”

“…In our study, the overall percentage of adult immigrants who reported receiving a tetanus booster dose within the preceding 10 years was 79.5% (95% CI: 75.8–82.8). This vaccination coverage is below the ultimate goal of achieving 100% [3], but is higher than the self-reported tetanus vaccination coverage among immigrants found in other countries, which ranges from 17.0% to 65.2% [9,13,15,16,17,18].…”

The Quick and Dirty: A Tetanus Case Report

“…At-risk patients include individuals over 50 years old and immigrants who may not have been fully immunized 13,14. As pointed out by Sanchez-Gonzalez et al, the latter group includes “all foreign-born, irrespective of their birthplace, citizenship, language and years of residence in the United States.” 8 According to the 2010 U.S. census, 12.9% or 40 million people in the U.S. are foreign born7 and as of 2016, 49.2 million Americans are 65 years or older 15. It is imperative to scrutinize the immunization history in these high-risk populations and administer immunoglobulin and tetanus vaccine as recommended.…”