Childhood Vaccination Coverage Rates Among Military Dependents in the United States

Angela C. Dunn · Carla L. Black · John C. Arnold · Stephanie K. Brodine · Jill Waalen · NANCY J. BINKIN

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Vaccine Coverage and Hesitancy Healthcare Policy and Management Child and Adolescent Health

Abstract

BACKGROUND AND OBJECTIVES: The Military Health System provides universal coverage of all recommended childhood vaccinations. Few studies have examined the effect that being insured by the Military Health System has on childhood vaccination coverage. The purpose of this study was to compare the coverage of the universally recommended vaccines among military dependents versus other insured and uninsured children using a nationwide sample of children. METHODS: The National Immunization Survey is a multistage, random-digit dialing survey designed to measure vaccination coverage estimates of US children aged 19 to 35 months old. Data from 2007 through 2012 were combined to permit comparison of vaccination coverage among military dependent and all other children. RESULTS: Among military dependents, 28.0% of children aged 19 to 35 months were not up to date on the 4:3:1:3:3:1 vaccination series excluding Haemophilus influenzae type b vaccine compared with 21.1% of all other children (odds ratio: 1.4; 95% confidence interval: 1.2-1.6). After controlling for sociodemographic characteristics, compared with all other US children, military dependent children were more likely to be incompletely vaccinated (odds ratio: 1.3; 95% confidence interval: 1.1-1.5). CONCLUSIONS: Lower vaccination coverage rates among US military dependent children might be due to this population being highly mobile. However, the lack of a military-wide childhood immunization registry and incomplete documentation of vaccinations could contribute to the lower vaccination coverage rates seen in this study. These results suggest the need for further investigation to evaluate vaccination coverage of children with complete ascertainment of vaccination history, and if lower immunization rates are verified, assessment of reasons for lower vaccination coverage rates among military dependent children.

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2015National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2014 2004Underimmunization Among Children: Effects of Vaccine Safety Concerns on Immunization Status 2014Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009 2009National, state, and local area vaccination coverage among children aged 19-35 months - United States, 2008.2003Maternal Characteristics Associated With Vaccination of Young Children 1995Factors Related to Immunization Status Among Inner-City Latino and African-American Preschoolers 2001Overview of the sampling design and statistical methods used in the National Immunization Survey21Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828.22The full text of this article is available via AJPM Online at www.elsevier.com/locate/ajpmonline.2001National, State, and Urban Area Vaccination Coverage Levels Among Children Aged 19-35 Months--United States, 2000

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