Associations between childhood vaccination status and medical practice characteristics among white, black, and Hispanic children

J Natl Med Assoc. 2009 Mar;101(3):229-35. doi: 10.1016/s0027-9684(15)30850-6.


Background: The purpose of the study was to identify and understand associations between characteristics of medical practices where immunization services are delivered and vaccination status among white, black, and Hispanic children aged less than 19 months.

Methods: Eighty pediatric and family physicians participated in a physician-patient encounters survey that included 684 children aged less than 19 months who received at least 1 vaccination during a randomly selected week in 2003.

Results: According to physicians' responses to survey questions, white children who used large medical practices, and black and Hispanic children who used practices, all enrolled in the Vaccine for Children (VFC) program, were more likely to receive vaccines at the recommended age, but Hispanic children who used large Medicaid practices were less likely to receive them at the recommended age. White children who used medical practices that had a large minority patient population were more likely to have completely missed whole series of vaccines.

Conclusion: Medical practice characteristics varied in importance as determinants of childhood vaccination among white, black, and Hispanic children. Understanding how type of medical practice and other medical practice characteristics may impact the receipt of timely preventive health services is vital to improving health care access in underserved populations.

MeSH terms

  • African Americans / statistics & numerical data*
  • Child
  • Child Welfare / statistics & numerical data
  • Child, Preschool
  • Confidence Intervals
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Health Services Accessibility / statistics & numerical data*
  • Hispanic Americans / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Male
  • Mass Vaccination / statistics & numerical data*
  • Multivariate Analysis
  • Odds Ratio
  • Pediatrics / statistics & numerical data
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Regression Analysis
  • United States