Adult vaccination disparities among foreign born populations in the United States, 2012
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Adult vaccination disparities among foreign born populations in the United States, 2012

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  • English

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    • Alternative Title:
      Am J Prev Med
    • Description:

      An estimated 13% foreign born persons are living in the United States. Foreign born persons are considered at higher risk of under-vaccination and exposure to several vaccine preventable diseases pre-migration or during return trips to their birth country. Information on vaccination coverage among foreign born populations is limited.


      To assess adult vaccination coverage disparities among foreign born populations in the United States.


      Data from the 2012 National Health Interview Survey were analyzed in 2013. For non-influenza vaccines, we calculated the weighted proportion vaccinated. For influenza vaccination, we used the Kaplan-Meier survival analysis to assess coverage among individuals interviewed during September 2011–June 2012 and vaccinated from August 2011–May 2012.


      Overall, unadjusted vaccination coverage among U.S. born respondents was significantly higher than that of foreign born respondents: influenza, ≥18 years (40.4% versus 33.8%); PPV, 18–64 years with high-risk conditions (20.8% versus 13.7%); PPV, ≥65 years (62.6% versus 40.5%); tetanus vaccination, ≥18 years (65.0% versus 50.6%); Tdap, ≥18 years (15.5% versus 9.3%); hepatitis B, 18–49 years (37.2% versus 28.4%); shingles, ≥60 years (21.3% versus 12.0%); and HPV, females 18–26 years (38.7% versus 14.7%). Exceptions were noted for hepatitis A vaccination among travelers and hepatitis B vaccination of persons ≥18 years with diabetes. Among the foreign born, vaccination coverage was generally lower for non-U.S. citizens, recent immigrants, and those interviewed in a language other than English. Foreign born were less likely than U.S. born to be vaccinated for pneumococcal (≥65 years), tetanus (≥18 years), Tdap (≥18 years), and HPV (women 18–26 years) after adjusting for confounders.


      Vaccination coverage was lower among foreign born adults than those born in the U.S. Vaccination coverage varied by immigration status, citizenship, language, and demographic characteristics. As the number of foreign born persons residing in the United States increases, it is important to consider foreign birth and immigration status when assessing vaccination disparities and planning interventions.

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