Predictors of pertussis vaccination among children aged 19-35 months in the United States, 2010-2011

Background: The incidence of pertussis in the United States has dramatically increased in the last decade. Four of five DTaP (diphtheria, tetanus, acellular pertussis) vaccine doses are recommended before age 19 months. The objective of this analysis was to identify variables associated with uptake of the first four recommended vaccine doses among children in the U.S. Methods: The National Immunization Survey captures data on children aged 19-35 months at the time of the survey. Data from 2010-2011 were included in weighted analysis using multivariate logistic regression to determine characteristics associated with the receipt of each of the first four pertussis-containing vaccines. Results: Poverty status, change in state residence, number of children in the household, provider facility type (public, hospital, private, or other), age group, and insurance status were all significant predictors of vaccine uptake. The odds of obtaining vaccines 2, 3, and 4 for children living in households with a high household income (over $75,000) were 1.92 (95% CI, 1.16-3.20), 1.76 (95% CI, 1.19-2.59), and 1.31 (95% CI, 1.04-1.65) times the odds of children living below the poverty threshold. The odds of uptake of vaccines 3 and 4 for children who have moved to a different state since birth were.58 (95% CI, .41-.83) and .57 (95% CI, .45-.73) compared to children whose state residence does not change. Discussion: Using a validated national data set, uptake of the first four pertussis vaccine doses is associated with poverty status, change in state residence, number of children in the household, provider facility type, age group, and insurance status.