Published online May 1, 2008
PEDIATRICS Vol. 121 No. 5 May 2008, pp. 938-944 (doi:10.1542/10.1542/peds.2007-1794)
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ARTICLE

Underimmunization of American Indian and Alaska Native Children

Amy V. Groom, MPHa,b, Michael L. Washington, PhDa, Philip J. Smith, PhDa and Ralph T. Bryan, MDb,c

a Immunization Services Division, National Center for Immunization and Respiratory Diseases
c Office of Minority Health and Health Disparities, Office of Strategy and Innovation, Office of the Director, Centers for Disease Control and Prevention, Atlanta, Georgia
b Division of Epidemiology and Disease Prevention, Office of Public Health Support, Indian Health Service, Albuquerque, New Mexico

OBJECTIVE. The goal was to determine whether disparities in childhood immunization coverage exist between American Indian/Alaska Native children and non-Hispanic white children.

METHODS. We compared immunization coverage with the 4 diphtheria-tetanus-pertussis, 3 poliovirus, 1 measles-mumps-rubella, 3 Haemophilus influenza type b, and 3 hepatitis B(4:3:1:3:3) series and its individual vaccine components (≥4 doses of diphtheria, tetanus, and pertussis vaccine; ≥3 doses of oral or inactivated polio vaccine; ≥1 dose of measles, mumps, and rubella vaccine; ≥3 doses of Haemophilus influenzae type b vaccine; and ≥3 doses of hepatitis B vaccine) between American Indian/Alaska Native children and non-Hispanic white children from 2000 to 2005, using data from the National Immunization Survey.

RESULTS. Although immunization coverage increased for both populations from 2001 to 2004, American Indian/Alaska Native children had significantly lower immunization coverage, compared with non-Hispanic white children, over that time period. In 2005, coverage continued to increase for American Indian/Alaska Native children but decreased for non-Hispanic white children, and no statistically significant disparity in 4:3:1:3:3 coverage was evident in that year.

CONCLUSIONS. Disparities in immunization coverage for American Indian/Alaska Native children have been present, but unrecognized, since 2001. The absence of a disparity in coverage in 2005 is encouraging but is tempered by the fact that coverage for non-Hispanic white children decreased in that year.

Key Words: American Indian • Alaska Native • immunization assessment • health disparities

Abbreviations: AI—American Indian • AN—Alaska Native • IHS—Indian Health Service • NIS—National Immunization Survey • 4:3:1:3:—4 diphtheria-tetanus-pertussis, 3 poliovirus, 1 measles-mumps-rubella, 3 Haemophilus influenza type b, and 3 hepatitis B • DT—diphtheria and tetanus toxoids • DTP—diphtheria-tetanus toxoids-pertussis • DTaP—diphtheria-tetanus-acellular pertussis • Hib—Haemophilus influenza type b

Accepted Sep 12, 2007.


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 Arch Pediatr Adolesc MedHome page
R. Singleton, S. Holve, A. Groom, B. J. McMahon, M. Santosham, G. Brenneman, and K. L. O'Brien
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