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US closes racial gap on child vaccinations

Mass. rate is highest

ATLANTA -- Toddlers in Massachusetts are more likely to be fully immunized than children in any other state, according to a report released yesterday by the US Centers for Disease Control and Prevention. Nearly 91 percent of Bay State children between ages 19 months and 35 months are vaccinated against diseases such as diphtheria, polio, measles, mumps, and hepatitis B.

Also, the report said that for the first time in at least a decade, the vaccination rate for black children in the United States has caught up to that of youngsters in other racial groups.

``This is an important milestone. It shows you that racial and ethnic differences can be eliminated" in health care, said Dr. Walter Orenstein, an Emory University vaccination expert.

The Centers for Disease Control and Prevention reported that a survey found no statistically significant difference in 2005 among blacks, whites, Asians, and Hispanics in vaccination rates for children ages 19 months to 35 months.

In each racial group, about 76 percent to 79 percent of children received the entire recommended series of shots against whooping cough, diphtheria, tetanus, polio, measles, mumps, rubella, chickenpox, hepatitis B, and Haemophilus influenza type B.

Blacks have lagged behind whites by as many as 10 percentage points in the past decade, said Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases.

In decades past, when fewer immunizations were recommended by the government, vaccination rates for different racial groups at times were roughly equal, Schuchat said. But disparities became clear during measles outbreaks in the late 1980s and early '90s. New public health efforts were started to close the gap, including the creation of the government's Vaccines for Children program in 1994, which pays for immunizations for the poor.

The overall numbers in the new report indicate public health officials still have work to do, said Dr. Neal Halsey, director of Johns Hopkins University's Institute for Vaccine Safety.

``Seventy-six percent is good, but it's not great. We still have a quarter of the children in this country not getting all the recommended vaccines in a timely manner," Halsey said.

The study was based on an annual random-digit-dialed telephone survey with a response rate of 65 percent. Researchers also reviewed vaccination records for about 17,500 children from households that took part in the survey.

Researchers found wide geographic variations. While Massachusetts had the highest vaccination rate, Vermont had the lowest, at 63 percent.

But racial gaps, which have been narrowing significantly in the past five or six years, seem to have closed, at least for now.

``This is the first year overall rates didn't vary" by race and ethnicity, Halsey said. ``But next year there can be a difference."

Vaccination rates rose in all the racial groups, most dramatically in blacks. In 2002, the vaccination rate was 62 percent for blacks, and 66 percent for whites and Hispanics, according to CDC data.

Orenstein, who led the CDC's immunization program until he left the CDC in 2004 for a position with Emory, deserves much of the credit for the closing of the gap, Halsey said. Racial gaps persist for some vaccines, the report said. Chickenpox vaccination rates were higher for black and Hispanic children than for white youngsters. But four-dose coverages of whooping cough, tetanus, and diphtheria, and pneumococcal conjugate vaccines were lower for blacks and Hispanics than for whites.

There was more good news: Overall vaccinations with pneumococcal conjugate vaccine have risen substantially since it was introduced in 2000, despite shortages. The percentage of children receiving three shots of the vaccine rose to 83 percent in 2005, up from 41 percent in 2002. The percentage receiving the full recommended four doses was up to 54 percent, from 36 percent in 2003.

Some vaccines have recently been added to the list of recommended immunizations for children, and that will increase the challenge to fully immunize children, Orenstein noted.

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