(Reuters Health) – Racial and ethnic disparities in vaccination rates have declined since the U.S. started a free childhood vaccine program more than two decades ago, but affluent and white youth are still more likely to get shots than their low-income and non-white peers, a recent study suggests.
Researchers focused on Vaccines For Children (VFC), a federal government initiative started in 1994 to provide vaccines at no cost to children who might not otherwise be vaccinated because of inability to pay. The U.S. Centers for Disease Control and Prevention (CDC) buys vaccines at a discount and distributes them across the country so doctors and clinics can give kids free shots.
The study compared vaccination rates in 1995 to 1997, just after the VFC program went into effect, with the rates in 2011 to 2013 and found that overall, vaccination against polio climbed from about 89 percent to roughly 93 percent.
For the measles, mumps and rubella vaccine (MMR), uptake rose from 90 percent to 92 percent. Use of the vaccine for diphtheria, tetanus, and pertussis – often called DTaP – increased from 80 percent to 83 percent.
“Prior to the program’s introduction, outbreaks of common communicable diseases such as measles remained quite high in the U.S.,” said lead study author Brendan Walsh of City University London in the U.K.
“These outbreaks were more common among low-income and non-white children who were not vaccinated,” Walsh added by email.
Despite overall gains in vaccination rates, racial, ethnic and economic disparities persist, Walsh and colleagues report in the journal Health Affairs.
They examined U.S. records on vaccination rates for children aged 19 months to 35 months based on race, ethnicity and household income from 1995 to 2013, focusing on three shots – MMR, DTaP and polio.
Among high-income white children, for example, 91 percent got at least four doses of the DTaP vaccine by the end of the study, compared with just 78 percent of low-income white kids.
For black children, DTaP vaccination rates were 89 percent for high-income kids and 76 percent of low-income kids at the end of the study.
With Hispanic kids, DTaP vaccination rates at the end of the study were 90 percent for high-income children and 81 percent for low-income children.
By the end of the study, MMR vaccination rates for at least one dose were 94 percent for high-income white kids and 95 percent for high-income black and Hispanic children. But among low-income kids, 89 percent of white children got the vaccine, compared with 90 percent of black children and 93 percent of Hispanic kids.
Vaccination rates for at least three doses of the polio vaccine among high-income kids were 96 percent among white and black children and 95 percent for Hispanic kids. Among the low-income groups, polio vaccination rates were 92 percent for white and Hispanic children and 91 percent for black kids.
Over its first two decades, the program prevented 322 million illnesses, helped avoid 732,000 deaths and saved nearly $1.4 trillion in direct healthcare costs and other costs to society, according to the CDC.
But the remaining disparities in vaccination rates suggest more still needs to be done to reach some children, Walsh said.
“Providing free vaccinations does not guarantee optimal uptake and some children, such as low-income black children, still have lower vaccination rates than their richer peers, as our study has shown,” Walsh said.
“Other potential barriers to vaccinations include travel costs, time costs, access to vaccination providers and lack of knowledge and fears about vaccinations,” Walsh added. “These factors need further research and may need to be addressed in order to increase vaccination rates further, particularly among low-income children.”