Full Citation
Title: Disparities and Trends in Routine Adult Vaccination Rates Among Disaggregated Asian American Subgroups, NHIS 2006-2018
Citation Type: Journal Article
Publication Year: 2022
ISBN:
ISSN: 2773-0654
DOI: 10.1016/J.FOCUS.2022.100044
NSFID:
PMCID:
PMID:
Abstract: Introduction Vaccination rates may be improved through culturally tailored messages, but little is known about them among disaggregated Asian-American subgroups. We assessed vaccination rates for key vaccines among these subgroups. Methods Using the National Health Interview Survey (NHIS), we analyzed recent vaccination rates (2015-2018, n=188,250) and trends (2006-2018) among Asians (Chinese [n=3165], Asian Indian [n=3525], Filipino [n=3656], other Asian [n=5819]), and non-Hispanic White (NHW) adults [n=172,085] for six vaccines (the Human Papillomavirus [HPV], hepatitis B, pneumococcal, influenza, tetanus-diphtheria [tetanus], and shingles vaccines). We controlled demographic, socioeconomic, and health-related variables in multivariable logistic regression and predicted marginal modeling analyses. We also computed vaccination rates among Asian-American subgroups on the 2015-2018 NHIS data stratified by foreign-born and US-born status. We used Joinpoint regression to analyze trends of vaccination rates. All analyses were conducted in 2021 and 2022. Results Among Asians, shingles (29.2%, 95% CI = [26.6%-32.0%]), tetanus (53.7%, 95% CI = [51.8%-55.6%]), and pneumococcal (53.8%, 95% CI = [50.1%-57.4%]) vaccination rates were lower than NHWs. Influenza (47.9%, 95% CI = [46.2%-49.6%]) and hepatitis B (40.5%, 95% CI = [39.0%-42.7%]) vaccination rates were similar or higher than NHWs (48.4%, 95% CI = [47.9%-48.9%] and 30.7%, 95% CI = [30.1%-31.3%], respectively). Among Asians, we found substantial variations in vaccination rates and trends. For example, Asian Indian women had lower HPV vaccination rates (12.9%, 95% CI = [9.1%-18.0%]) than all other Asian subgroups (Chinese: 37.9%, 95% CI = [31.1%-45.2%]; Filipinos: 38.7%, 95% CI = [29.9%-48.3%]; Other Asians: 30.4%, 95% CI = [24.8%-36.7%]), and non-Hispanic whites (36.1%, 95% CI = [34.8%-37.5%]). Being male, lower education attainment and income, no health insurance or covered by public health insurance only, and lower frequency of doctor visits were generally associated with lower vaccine uptakes. Foreign-born Asian aggregate had lower vaccination rates than US-born Asian aggregate for all vaccines except influenza. We also found subgroup-level differences in vaccination rates between foreign-born and US-born Asians. Compared to their respective US-born counterparts, (a) foreign-born Chinese, Asian Indians, and other Asians had lower HPV and hepatitis B vaccination rates, (b) foreign-born Chinese and Filipinos had lower pneumococcal vaccination rates, (c) foreign-born Chinese and Asian Indians had lower influenza vaccination rates, and (d) all foreign-born Asian subgroups had lower tetanus vaccination rates. Conclusion Vaccination rates and trends differed among Asian-American subgroups. Culturally tailored messaging and interventions may improve vaccine uptakes.
Url: https://www.sciencedirect.com/science/article/pii/S2773065422000426
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Authors: Wang, Ziqing; Jamal, Armaan; Wang, Ryan; Dan, Shozen; Kappagoda, Shanthi; Kim, Gloria; Palaniappan, Latha; Long, Jin; Singh, Jaiveer; Srinivasan, Malathi
Periodical (Full): AJPM Focus
Issue: 1
Volume: 2
Pages: 1-13
Data Collections: IPUMS Health Surveys - NHIS
Topics: Health, Race and Ethnicity
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