American Journal of Public Health
Volume 104, Issue 1 (January 2014)
http://ajph.aphapublications.org/toc/ajph/current

Effect of Vaccination Coordinators on Socioeconomic Disparities in Immunization Among the 2006 Connecticut Birth Cohort
Jessica A. Kattan, Kathy S. Kudish, Betsy L. Cadwell, Kristen Soto, James L. Hadler
American Journal of Public Health: January 2014, Vol. 104, No. 1: e74–e81.
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301418

Abstract
Objectives. We examined socioeconomic status (SES) disparities and the influence of state Immunization Action Plan–funded vaccination coordinators located in low-SES areas of Connecticut on childhood vaccination up-to-date (UTD) status at age 24 months.

Methods. We examined predictors of underimmunization among the 2006 birth cohort (n = 34 568) in the state’s Immunization Information System, including individual demographic and SES data, census tract SES data, and residence in an area with a vaccination coordinator. We conducted multilevel logistic regression analyses.

Results. Overall, 81% of children were UTD. Differences by race/ethnicity and census tract SES were typically under 5%. Not being UTD at age 7 months was the strongest predictor of underimmunization at age 24 months. Among children who were not UTD at age 7 months, only Medicaid enrollment (adjusted odds ratio [AOR] = 0.6; 95% confidence interval [CI] = 0.5, 0.7) and residence in an area with a vaccination coordinator (AOR = 0.7; 95% CI = 0.6, 0.9) significantly decreased the odds of subsequent underimmunization.

Conclusions. SES disparities associated with underimmunization at age 24 months were limited. Efforts focused on vaccinating infants born in low SES circumstances can minimize disparities.