Clustering of pertussis cases around immunization exemption clusters in New Mexico Open Access

Clippard, Jessie R. (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/2801ph191?locale=en
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Abstract



Abstract

Clustering of pertussis cases around immunization exemption clusters in New Mexico
By Jessie R. Clippard
It is important for states to monitor immunization coverage at a level finer than statewide.
Pockets of unimmunized children have been found to be associated with clusters of several
communicable diseases (e.g., measles, pertussis). However, the relationship between
geographically clustered immunization exemptions to preschool and grade school
immunization requirements and geographically clustered pertussis cases within a state with a
strict and difficult immunization exemption acquisition process has not been previously
examined. We analyzed pertussis case data for children less than 18 years of age as wel as
immunization exemption data from 2006-2009 in New Mexico using a Geographic
Information System (GIS). Being located within an exemptions cluster was associated with
higher odds of also being located within a cluster of pertussis. With the awareness of these
exemption clusters, public health officials and individual communities can be aware of a
greater risk for communicable disease outbreaks in these areas. This study demonstrates
support for the need for finer examination and reporting of immunization coverage.


Clustering of pertussis cases around immunization exemption clusters in New Mexico
By
Jessie Clippard
Bachelor of Science
The Pennsylvania State University
2009
Faculty Thesis Advisor: Dr. Kevin Sullivan
A thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfil ment of the requirements for the degree of
Master of Public Health
in Epidemiology
2011

Table of Contents


1
Table of Contents
LIST OF TABLES & FIGURES
2
LITERATURE REVIEW
3
MANUSCRIPT
13
ABSTRACT
13
INTRODUCTION
14
METHODS
18
RESULTS
22
DISCUSSION
24
TABLES
29
FIGURES
35
REFERENCES
36
APPENDIX A
45
APPENDIX B
46
APPENDIX C
47
APPENDIX D
48
APPENDIX E
49
APPENDIX F
50
APPENDIX G
51
APPENDIX H
52
APPENDIX I
53


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