1653. Socio-demographic Factors Associated with Immunization Requirement Exemptions in New York State
Session: Poster Abstract Session: Programmatic Adjustments to Improve Vaccine Coverage
Saturday, October 20, 2012
Room: SDCC Poster Hall F-H

Socio-demographic Factors Associated with Immunization Requirement Exemptions in New York State.

J. Shaw, B. Tserenpuntsag, D. Blog, N. Halsey, and D. Easton

Background: There is evidence of substantial geographic heterogeneity in non-medical exemption rates between and within US states. The reasons for geographic clustering are not fully understood. The objective of this study was to look for predictors for immunization requirement exemptions at the county level in New York State (NYS).

Methods: Religious exemption prevalence rates were calculated using NYS Department of Health (NYSDOH) School Surveys from 2000-2010. Demographic and socioeconomic characteristics of the counties were obtained from 2000 US Census Bureau and NYSDOH county profiles. Counties were stratified into two categories: high (exemption prevalence ≥1%) and low (<1%). Logistic regression model was used to identify community factors associated with high exemption prevalence rate.

Results: Data was available on all 62 counties in NYS. The high and low exemption counties were similar in regards to their population education level, number of students in private schools, median income, and percentage of people living under the poverty level. Black race was more prevalent in counties with low exemptions (p<0.05). In the multivariate analysis, white population and people living under poverty level were associated with higher exemption prevalence, p<0.05. The mean exemption prevalence in private schools was higher when compared to public schools, 2.8% vs 0.4% (p<0.001) and increased significantly over 11 year period, p<0.05 (graph).

Conclusion: Private schools have higher exemptions to immunization requirements and their prevalence increased over time in NYS. An increase in people under the poverty level is likely to increase number of unvaccinated children in the community. Other factors not included in this study such as recent population migration, access to health care, household size, marital status, and knowledge about immunization benefits at the individual level deserve further study. 



Jana Shaw, MD, MPH1, Boldtsetseg Tserenpuntsag, PhD2, Debra Blog, MD, MPH2, Neal Halsey, MD3 and Delia Easton, PhD2, (1)Pediatrics, SUNY Upstate Medical University, Syracuse, NY, (2)NYSDOH,Bureau of Immunization, Albany, NY, (3)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD


J. Shaw, None

B. Tserenpuntsag, None

D. Blog, None

N. Halsey, None

D. Easton, None

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