Childhood Vaccine Refusal by Immigrant Groups

By John D. Cowden, MD, MPH

Dr. Cowden is associate editor of NEJM Journal Watch Pediatrics and Adolescent Medicine, from which this story was adapted. Full coverage is available with a subscription at the link below.

Children of Somali, Ukrainian, and Russian immigrants had lower rates of vaccination for specific vaccines than children of U.S.-born parents, according to a Pediatrics study.

Researchers examined Washington State’s vaccine registry to compare vaccination rates between children of immigrant parents (at least one parent born in Somalia, Ukraine, Russia, Mexico, or India) and children of two U.S.-born parents. When children were 12–23 months old, their records were assessed for receipt of at least one dose of measles-containing vaccine; diphtheria, tetanus, acellular pertussis-containing vaccine; hepatitis A (HepA) vaccine; and pneumococcal vaccine.

Compared with children born of U.S. parents, those of Somali parents were less likely to have received a measles-containing vaccine (76% vs. 92%); those of Ukrainian and Russian parents were less likely to receive all four vaccines, particularly HepA (55% and 69%, respectively, vs. 81%); and those of Mexican and Indian parents were more likely to receive all four vaccines.

Comment: Practitioners caring for children of immigrants should seek to understand not only who refuses what, but also the reasons for refusal. I have found that valuing a family’s beliefs and concerns, even if I do not share them, builds trust, which is an essential ingredient in persuading vaccine-hesitant parents.