Vaccination coverage of foreign-born children 19 to 35 months of age: findings from the National Immunization Survey, 1999-2000.

OBJECTIVE To compare coverage estimates of foreign-born children 19 to 35 months old with those of US-born children of the same age group. METHODS The National Immunization Survey is a multistage, random-digit dialing survey designed to measure vaccination coverage estimates of US children 19 to 35 months old. Data from 1999-2000 were combined to permit comparison of vaccination coverage among foreign- and US-born children. RESULTS Foreign-born and US-born children 19 to 35 months of age had comparable 3:3:1 series coverage (3 or more doses of diphtheria and tetanus toxoids and pertussis vaccine [DTP/DTaP/DT], 3 or more doses of poliovirus vaccine, and 1 or more doses of measles-containing vaccine), the standard in most countries. However, coverage for a US standard, 4:3:1:3 series (4 or more doses of DTP/DTaP/DT, 3 or more doses of poliovirus vaccine, 1 or more doses of measles-containing vaccine, and an adequate number of Haemophilus influenzae type b [Hib] doses based on age at first dose) was lower among foreign-born children because of markedly lower Hib cover and marginally lower DTP/DTaP/DT coverage. In addition, hepatitis B coverage was markedly lower in foreign-born children. CONCLUSION Lower vaccination coverage among foreign-born children, especially against Hib and hepatitis B, is of concern because foreign-born children often live in households and communities characterized by more intense exposure to these diseases, and many originate from countries with much higher prevalence rates of these diseases than the United States. The differences in Hib and hepatitis B coverage suggest a need for increased culturally competent public health immunization interventions to increase coverage among foreign-born children.