Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106445

Kenneth D. Rosenberg, MD, MPH¹, Liang Wu, MA², Martha W. Priedeman, MPH¹, Stacey S. Schubert, MPH³, David W. Fleming, MD⁴, and Weiyi Zhao⁵. (1) Office of Family Health, Oregon Department of Human Services, 800 NE Oregon Street, Suite 850, Portland, OR 97232, 503-731-4507, ken.d.rosenberg@state.or.us, (2) Community and Business Services Department, Multnomah County, 501 SE Hawthorne Boulevard, Suite 531, Portland, OR 97214, (3) Office of Disease Prevention and Epidemiology, Oregon Department of Human Services, 800 NE Oregon Street, Suite 730, Portland, OR 97232, (4) Global Health Strategies, Bill & Melinda Gates Foundation, P.O. Box 23350, Seattle, WA 98102, (5) Oregon State University, 12750 SW 107th Court, Tigard, OR 97223

Introduction. Immunization status is the most easily measured of a wide range of child health outcomes that might be affected by insurance status. Methods. On November 1, 1996, a stratified random sample of 3149 Oregon births age 19-35 months old (DOB 11/1/93-4/1/95) was selected. After exclusions, 80.4% (2452/3048) of their families were interviewed and their immunization histories verified. Using three core childhood immunizations (4 DTP, 3 OPV and 1 MMR), children were placed in one of three mutually exclusive categories of immunization status: Fully (8), Almost (5-7) and Poorly (1-4). The children with 0 immunizations were excluded from this analysis. Results. 81.0% of the children were Fully immunized with 8 immunizations at 19-35 months. 15.5% were Almost immunized (5-7 shots), 2.1% were Poorly Immunized (1-4 shots) and 1.4% were Unimmunized (0 shots). Insurance status was associated with immunization status. We compared Poorly immunized children with Fully immunized children. In a multivariate logistic model, children with no health insurance were more likely to be poorly immunized than children with insurance: ORa 4.1 (95% CI 1.2-14.1). Conclusions. Children with no insurance were more likely to be Poorly immunized than those with insurance. They were therefore vulnerable to clinical vaccine-preventable disease. Immunization status is also a proxy for risk of other disease. State Child Health Insurance Health (SCHIP) programs provide insurance for children in near-poor families; they are being limited because of tight state budgets. These programs need to be fully funded.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Know how to assess immunization status in a population
• Understand the association between insurance and immunization status
• Identify risk factors for underimmunization

Keywords: Immunizations, Insurance

Related Web page: www.dhs.state.or.us/publichealth/imm/kids/survey/s2yroldslow.pdf#search='Oregon%20Immunization%20Survey%20of%20TwoYearOlds'

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.