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 NTU scientists build new ultrasound device using 3-D printing technology
07.12.2016 | Nanyang Technological University

nachricht How to turn white fat brown
07.12.2016 | University of Pennsylvania School of Medicine

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: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

NTU scientists build new ultrasound device using 3-D printing technology

07.12.2016 | Health and Medicine

The balancing act: An enzyme that links endocytosis to membrane recycling

07.12.2016 | Life Sciences

How to turn white fat brown

07.12.2016 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>