Published online April 1, 2008
PEDIATRICS Vol. 121 No. 4 April 2008, pp. e768-e774 (doi:10.1542/10.1542/peds.2007-0305)
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ARTICLE

Vaccination Coverage by Special Health Care Needs Status in Young Children

Kathleen S. O'Connor, MPH and Matthew D. Bramlett, PhD

Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Health Interview Statistics, Hyattsville, Maryland

OBJECTIVE. The purpose of this study was to compare vaccination coverage among children 19 to 35 months of age with and without special health care needs overall and among demographic subgroups.

METHODS. Data are from the National Survey of Children With Special Health Care Needs, a module of the State and Local Area Integrated Telephone Survey, which was sponsored by the Health Resources and Services Administration Maternal and Child Health Bureau and conducted in 2000–2002 by the Centers for Disease Control and Prevention National Center for Health Statistics. We used data from the National Immunization Survey and the National Survey of Children With Special Health Care Needs to examine immunization coverage rates for individual vaccines and an array of combined series vaccinations. The relationship between special needs and immunization status was analyzed by age, gender, and race or ethnicity of the child; the child's health insurance type; the mother's educational attainment and presence in the household; and household income relative to the federal poverty level.

RESULTS. Overall, there were no significant differences between children with and without special needs for any of the individual antigens or combined immunization series. Some significant differences by special needs status were found within certain demographic subgroups.

CONCLUSIONS. Our results suggest that, generally children with special health care needs have immunization rates that are very similar to typically developing children. There is some evidence that children with special health care needs are at risk for underimmunization if they are non-Hispanic white or live in an affluent household and are more likely to be immunized if they are Hispanic, poor, publicly insured, or if their mothers did not complete high school. These findings may be due to outreach or support programs that target disadvantaged children. However, it is important to note that the majority of comparisons within demographic subgroups show no significant differences between children with special health care needs and children without special health care needs.

Key Words: vaccination • children with special health care needs

Abbreviations: CDC—Centers for Disease Control and Prevention • DTP—diphtheria and tetanus toxoids and pertussis vaccine • DT—diphtheria and tetanus toxoids vaccine • DTaP—diphtheria and tetanus toxoids and acellular pertussis vaccine • 4:3:1—combined series composed of ≥4 doses of DTP/DT/DTaP, ≥3 doses of poliovirus vaccine, and ≥1 dose of MCV • 4:3:1:3—combined series composed of the 4:3:1 plus ≥3 doses of Hib vaccine • 4:3:1:3:3: combined series composed of the 4:3:1:3 plus ≥3 doses of hepatitis B vaccine • CSHCN—children with special health care needs • MCHB—Maternal and Child Health Bureau • NIS—National Immunization Survey • NS-CSHCN—National Survey of Children With Special Health Care Needs • SLAITS—State and Local Area Integrated Telephone Survey • FPL—federal poverty level • MMR—measles, mumps, and rubella vaccine • Hib—Haemophilus influenzae type b • MCV—measles-containing vaccine

Accepted Aug 27, 2007.


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