Influenza vaccination among U.S. pediatric patients receiving care from federally funded health centers

Abstract

Introduction: During the 2018-2019 influenza season, vaccination coverage among U.S. children was 62.6%. The purpose of this study was to estimate the prevalence of influenza vaccinations among pediatric patients seen in U.S. health centers, and to explore potential disparities in vaccination coverage among subpopulations. Funded by the Health Resources and Services Administration (HRSA) within the U.S. Department of Health and Human Services, these health centers provide primary and preventive care to underserved and vulnerable individuals and families in order to reduce health disparities based on economic, geographic, or cultural barriers. Methods: Cross-sectional data, analyzed in 2019, came from the most recent waves of the Health Center Patient Survey (2009, 2014). The sample consisted of children ages 2-17 years receiving care from HRSAfunded health centers. The outcome of interest was self-or parent-reported receipt of influenza vaccine in the past year. Multivariable logistic regression was used to estimate the adjusted prevalence rate ratios for the association between demographic characteristics (age, sex, race/ethnicity, poverty level, urban/rural residence, geographic region), health-related variables (receipt of well-child checkup , asthma diagnosis), and influenza vaccination. Results: Influenza vaccination coverage among pediatric health center patients increased from 46.6% in 2009 to 67.8% in 2014. In the adjusted model for 2014, there were few statistically significant differences in vaccination coverage among subpopulation groups, however American Indian/Alaska Native children had 31% increased vaccination coverage compared with non-Hispanic White children (aPRR: 1.31, 95% CI: 1.02-1.60) and children living in the South had 26% decreased vaccination coverage compared with those living in the Northeast (aPRR: 0.74, 95% CI: 0.54-0.93). Conclusions: Influenza vaccination coverage among pediatric health center patients in 2014 exceeded the national average (as of 2018-2019), and few differences were found among at-risk subpopulations. HRSA-funded health centers are well-positioned to further increase the vaccination rate among children living in underserved communities.

Barriers to and facilitators of early childhood immunization in rural areas of the United States: A systematic review of the literature

“…A barrier to early childhood vaccination identified across many studies was vaccine hesitancy, which the World Health Organization defines as “a delay in acceptance or refusal of vaccination despite the availability of vaccination services” ( MacDonald, 2015 , World Health Organization, 2014 ). Although vaccine hesitancy is not limited to rural communities ( Larson et al, 2014 ), studies that have investigated the intersection of hesitancy and regionality demonstrate that more research is necessary to understand vaccine-hesitant concerns and behaviors at a community level, including within rural communities ( Hausman et al, 2020 , Lebrun-Harris et al, 2020 , Vanderpool et al, 2015 ). While it is established that rural children and adolescents are undervaccinated compared to their urban counterparts nationally, it is unclear how much of this disparity is due to increased vaccine hesitancy in rural communities versus other barriers to preventive care access experienced by rural families ( Hill et al, 2020 , Walker et al, 2019 ).…”

Diné teachings and public health students informing peers and relatives about vaccine education: Providing Diné (Navajo)-centered COVID-19 education materials using student health messengers

“…Vaccine uptake is critical in Native American populations as national data indicate that Native Americans have disproportionally high levels of pre-existing health conditions and have the highest rates of COVID-19-related mortality compared to other US populations ( 10 , 11 ). Prior to the COVID-19 pandemic, Native Americans had higher vaccine rates than the general US populations, noted particularly for influenza and human papillomavirus infection ( 12 , 13 ). Based on a review of social media discussions among NN residents, COVID-19 vaccine hesitancy is grounded in historical mistrust of the government ( 14 , 15 ).…”