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:
"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:
"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.
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!
Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania
The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).
Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...
Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.
The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...
10.01.2017 | Event News
09.01.2017 | Event News
05.01.2017 | Event News
17.01.2017 | Earth Sciences
17.01.2017 | Materials Sciences
17.01.2017 | Architecture and Construction