Childrens Immunization Status Worsens as Mothers Income, Education Rise

Mothers with more income and education may be less likely to keep their childrens immunizations up-to-date, a large new study finds. Children in the poorest Hispanic and non-Hispanic black families were more likely to have received the recommended childhood vaccinations compared to children of non-Hispanic white mothers.

This finding, at least in the case of immunization, indicates that higher income and education is not a predictor of being up-to-date, said Patrick Rivers, PhD, study co-author and associate professor at Southern Illinois University in Carbondale.

The study appears in the February issue of the American Journal of Public Health.

Parents of 11,860 children ages 19 to 35 months answered questions about income, marital status and race/ethnicity and noted whether their children had completed the recommended childhood vaccinations by 18 months of age. Researchers verified the parents responses by comparing them to records from health care providers who administered the vaccines.

Researchers discovered that 52.9 percent of non-Hispanic white children in the sample did not have up-to-date immunizations, compared with 22.7 percent of Hispanic children and 16.1 percent of non-Hispanic black children.

Children with Hispanic mothers and children residing in households with income [below the poverty line] were most likely to have received the required immunizations at or before 18 months from birth, Rivers said.

Access to government-subsidized healthcare programs and a cultural emphasis on child well-being may contribute to higher immunization rates in minority populations, the authors suggest.

Immunization completion rates were also higher among children of mothers with less than 12 years of education, compared to children of mothers with college degrees.

This finding is surprising because we would expect mothers with higher levels of education to be more knowledgeable about the importance of vaccines, Rivers said. But, he suggested, educated mothers are more likely to have time-consuming jobs, which may contribute to missed immunization appointments.

The analysis showed that children living with single mothers were less likely to have completed the required immunizations.

Women who are raising two or more children under age 18 by themselves have a tough time getting their children immunized, said Sally Findley, Ph.D., a professor at Columbia University who is not affiliated with the study.

It is not race, ethnicity or poverty per se, she said, but the interaction between the family situation and social influences that impacts immunization rates.

Parents need to be proactive about immunizations, regardless of their income, race, ethnicity, or family or social situation, Findley said.

Reference: Kim SS, et al. Effects of maternal and provider characteristics on up-to-date immunization status of children aged 19 to 35 months. Am J Public Health 97(2), 2007.