Access Barriers to Childhood Immunizations: A Statewide Population-Based Study

Background: Nevada is routinely ranked in the lower tier of preschool immunizations. Factors contributing to low vaccination rates identified in literature include system-level access, provider challenges, and parental beliefs. This project searched for any barriers to acquiring vaccinations as reported by state residents using data from a special module added to the Behavioral Risk Factor Surveillance System.

Methods: Questions on childhood immunization were added to the 2007 and 2008 Nevada BRFSS project. Weighted logistic regressions were conducted.

Results: 8,870 Nevadan parents and caregivers have reported access barriers to vaccinations. The parents with barriers were more likely to be female (AOR; 2.22, CI, 1.20 – 4.10; p < 0.05), Black (AOR, 2.89; CI, 1.07 – 7.82; p < 0.05), have a household income of <$5,000 (AOR, 2.38; CI 1.24 – 4.57; p < 0.01), and have a child aged between 0-3 years old (AOR, 2.10; CI 1.16-3.80; p < 0.05). Grandparents that are caregivers had a protective factor on barriers to vaccinations (AOR, 0.12; CI 0.03-0.52; p =0.004). Other results included the belief that it was too costly to see a physician (AOR, 3.27; CI 1.80-5.94; P<.001), however, there were no significant findings regarding healthcare coverage.

Conclusions: Immunization disparities are prevalent in Nevada despite existing programs. As with other health services, financial constraints (and misperceptions about them) deter the vaccination of children. Increased awareness of cost-free programs for patients and providers could help address this need. Concerns about safety can be addressed with additional education on the importance of vaccines.