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Since 1997, the Georgia Immunization Office has conducted the annual Georgia Immunization Study (GIS) – a retrospective cohort study to determine the statewide and regional immunization coverage rates for 24 month old children born in the state of Georgia. In 2010, data collection was expanded to include reasons for incomplete immunization. This study aims to assess the contribution of vaccine hesitancy to inadequate immunization in Georgia.
METHODS:
We analyzed data from the Georgia Registry of Immunization Transactions and Services (GRITS), which provided information on approximately 7,000 children who received immunizations during 2010-2012. We assessed the proportion of children who were inadequately immunized (4:3:1:3:3:1:4 level), analyzed the reasons listed for inadequate immunization, and used descriptive statistics to characterize demographic or other factors that may contribute to vaccine hesitancy - measured as parent choosing delayed schedule or refusing any vaccines.
RESULTS:
During 2010-2012, a total of 462 (6.5%) two-year-olds were inadequately immunized by the end of the data collection period. During this time, there were a total of 261 (56.5%) reasons for inadequate immunization related to vaccine hesitancy, the most-frequently cited reason being “parent chose a delayed schedule” (141; 30.5%). The racial/ ethnic breakdown of the inadequately immunized subsample was: white, non-Hispanic (215; 46.5%), black, non-Hispanic (166; 35.9%) and Hispanic (28; 6.1%), similar to the overall eligible sample. The white, non-Hispanic children were inadequately immunized due primarily to a parent refusing one or more vaccines (48; 16.9%) versus children of black and Hispanic mothers (18; 5.0% and 5; 8.3%, respectively). Parents of children enrolled in WIC less often refused one or more vaccines when compared to parents of children not enrolled in WIC (10% versus 21%) (2011). Parents of children whose mother was 25-34 years old at the time of birth more often chose a delayed immunization schedule for their child than both the under 25 year and 35+ years age groups (79; 35.1% versus 51; 27.4% and 11; 21.6%, respectively).
CONCLUSIONS:
Inadequate immunization may be attributed, in part, to vaccine hesitancy in more than 2.5% of the cohort of two year olds in Georgia during 2010-2012. Inadequately immunized children differ by race/ethnicity, maternal age, and maternal WIC enrollment. Healthcare providers should take into account these differences to target vaccine education and improve vaccine coverage in Georgia.