262031 Access Barriers to Childhood Immunizations: A Statewide Population-Based Study

Wednesday, October 31, 2012 : 11:20 AM - 11:35 AM

Dane Bay, MPH , School of Community Health Sciences, University of Nevada Reno, Reno, NV
Daniel Cook, PhD , School of Community Health Sciences, University of Nevada Reno, Reno, NV
Erin Seward, MPH , Immunizations Program, Nevada State Health Division, Carson City, NV
Wei-Chen Tung, PhD, RN , Nursing, University of Nevada at Reno, Reno, NV
Wei Yang, PhD, MD , School of Community Health Sciences, University of Nevada Reno, Reno, NV
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.

Learning Areas:
Epidemiology
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public

Learning Objectives:
Describe survey responses about reasons given by parents for inability to obtain vaccinations for children in Nevada. Formulate potential improvements to health services with policies and procedures that promote access to vaccinations in the United States.

Keywords: Access to Health Care, Immunizations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am faculty of public health with a doctoral degree in political science and certificate in health services research. I supervised this research conducted by an MPH student who graduated in 2011.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.