Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study identifies geographic clusters of underimmunization in Northern California

19.01.2015

Researchers used spatial analysis software and electronic medical records to identify clusters of underimmunization and vaccine refusal among Kaiser Permanente members in Northern California, according to a study published today in the journal Pediatrics.

Children are considered to be underimmunized when they miss one or more recommended vaccine doses before age three, while vaccine refusal means not allowing a child to receive any vaccines.

The study reviewed the immunization records of more than 154,000 Kaiser Permanente Northern California members between birth and 3 years old. All the children were born between 2000 and 2011 and were covered continuously by Kaiser Permanente, which provides health care for about 40 percent of the insured population in 13 Northern California counties. To identify the clusters of underimmunization and vaccine refusal, researchers used sophisticated spatial analysis software, which allowed them to examine health factors in relation to geography.

The Centers for Disease Control's immunization schedule recommends a minimum of 17 separate injections during a child's first two years of life, including for hepatitis A and B, diphtheria, tetanus, pertussis, influenza, polio, measles, mumps, rubella, and pneumococcal virus. Underimmunization is associated with elevated risk of vaccine-preventable disease, while nonmedical immunization exemption and refusal have been associated with increased community risk of measles and pertussis.

"This research confirms anecdotal reports of underimmunization clusters," said Tracy A. Lieu, MD, MPH, the study's lead author, a Kaiser Permanente pediatrician, and director of the Kaiser Permanente Division of Research. "In addition, we found clusters in places we hadn't anticipated."

Dr. Lieu noted that this study will be useful for targeting outreach efforts in particular areas, although it was not designed to figure out why children in some areas are less likely to be fully immunized.

"Everyone in the Kaiser Permanente health care system has access to vaccines, and since childhood vaccination is covered by insurance, financial barriers are not an issue," Dr. Lieu said. "Our findings raise awareness that there may be communities where parents have more vaccine hesitancy and may be interested in more information or more in-depth conversations with their children's doctors."

Underimmunization ranged from 18 percent to 23 percent within clusters, compared with 11 percent outside clusters. Between 2010 and 2012, geographic clusters of underimmunization were found in:

  • the East Bay (Richmond to San Leandro);
  • Sonoma and Napa counties;
  • a small area of east Sacramento;
  • northern San Francisco and southern Marin counties; and
  • a small area of Vallejo.

"Shot limiting," in which parents limit the number of injections or antigens that children receive during a pediatric visit to two or fewer, was found to cluster in similar areas.

Vaccine refusal ranged from 5.5 percent to 13.5 percent within clusters, compared with 2.6 percent outside clusters. Between 2010 and 2012, geographic clusters of vaccine refusal were found in:

  • the East Bay (El Cerrito to Alameda);
  • Marin and southwest Sonoma counties;
  • northeastern San Francisco;
  • northeastern Sacramento County and Roseville; and
  • a small area south of Sacramento

"Kaiser Permanente's electronic medical record system is among the richest in the world," Dr. Lieu said. "This is the first time that spatial analysis techniques have been applied to real-time vaccine data."

###

In addition to Lieu, co-authors of the study are G. Thomas Ray, MBA, Kaiser Permanente Division of Research; Nicola P. Klein, MD, PhD, Kaiser Permanente Vaccine Study Center; Cindy Chung, MD, Kaiser Permanente San Rafael Medical Center; and Martin Kulldorff, PhD, Harvard Pilgrim Health Care and Harvard Medical School.

About the Kaiser Permanente Division of Research

The Kaiser Permanente Division of Research (DOR) conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR's 500-plus staff is working on more than 250 epidemiological and health services research projects. For more information, visit http://www.dor.kaiser.org or follow us at @kpdor

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve approximately 9.5 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

Cyrus Hedayati | EurekAlert!

Further reports about: Medical Sacramento Vaccine health care health services immunization injections measles vaccines

More articles from Health and Medicine:

nachricht One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center

nachricht The gut microbiota plays a key role in treatment with classic diabetes medication
01.06.2017 | University of Gothenburg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Quantum thermometer or optical refrigerator?

23.06.2017 | Physics and Astronomy

A 100-year-old physics problem has been solved at EPFL

23.06.2017 | Physics and Astronomy

Equipping form with function

23.06.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>