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Black Children Lag on Vaccines

White, Latino and Asian kids vaccinated at same rate

WEDNESDAY, June 2, 2004 (HealthDayNews) -- Researchers who launched a routine review of immunizations of American preschoolers have uncovered a disturbing trend: While more white kids are completing the full course of recommended vaccines, the rate among black children has stayed the same.

In other words, there's a color gap, and it's growing.

"The trend isn't going in the direction we had been assuming. If we don't start thinking about why this is going on, the gap could widen to the extent that it undermines the success we've built up so far," said study co-author Susan Y. Chu, associate director for science at the National Immunization Program.

Chu and her colleagues studied U.S. vaccination rates among preschool children from 1996 to 2001, comparing the levels among whites, blacks, Latinos and Asians. In the last year of the study, 2001, the researchers studied the vaccination records of more than 20,000 children.

The researchers focused on whether the kids had received the recommended doses of vaccines that protect against diphtheria, pertussis, tetanus, polio, measles, influenza and hepatitis B. Many of the vaccines must be given three times or more to be fully effective.

The findings of the study appear in the June issue of the American Journal of Public Health.

Among whites, the percentage of fully immunized preschoolers rose from 69 percent in 1996 to 75 percent in 2001. Immunization rates grew even more among Latinos, from 64 percent in 1996 to 74 percent five years later, while the rates for Asians stayed steady at about 74 percent.

But among black children, the rate of immunization stood at 67 percent in both 1996 and 1997.

The reasons for the racial gap aren't entirely clear, nor do researchers understand why it widened over five years. In 1996, "disparities for many of the vaccines were pretty much gone," Chu said.

One theory is that changes in the health-care system, including more expensive insurance coverage, may play a role. Also, immunization schedules have become more complicated.

"To get a child fully vaccinated involves a lot of trips to the doctor and support from the provider," Chu said. "It's not like getting four or five shots, it's like getting 16 to 18 by the time they're 2 years old. For a lot of young parents in particular, that's very difficult."

Another factor may be skepticism about the value of immunization, she said.

Dr. Leonard E. Egede, an assistant professor of medicine at the Medical University of South Carolina who studies the effect of race upon health care, said the study researchers pinpointed a problem in federal immunization efforts.

"It suggests that despite what's been going on at the national level, it's not translating into direct benefit for patients," he said.

The findings aren't unusual, Egede added. Many studies have shown that minority patients receive worse care than whites, even when researchers take pains to compare people with similar incomes.

More information

The U.S. Centers for Disease Control and Prevention has more on childhood vaccinations.

SOURCES: Susan Y. Chu, Ph.D., M.S.P.H., associate director, science, National Immunization Program, U.S. Centers for Disease Control and Prevention, Atlanta; Leonard E. Egede, M.D., M.S., assistant professor, medicine, Medical University of South Carolina, Charleston; June 2004 American Journal of Public Health
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