The Effect of Birth Month on Influenza Immunization among Infants Ages 6-23 Months: Evaluation Using the New York State Immunization Information System Pubblico

Abstract

BACKGROUND AND OBJECTIVES: Since 2004, the Advisory Committee on Immunization Practices has recommended annual influenza vaccination for children ages 6-23 months. Influenza vaccine demand peaks by November and declines in subsequent months. This seasonality may prevent all children from receiving their first dose of influenza vaccine upon becoming eligible. The objective of this study was to assess the relationship between infant birth month and receipt of influenza vaccine by age 23 months.

METHODS: All children with demographic or immunization data in the New York State Immunization Information System born between 2009-2013 who survived through January 2016 were included in the study. Risk ratios were estimated using log-binomial regression. Risk ratios for receipt of influenza vaccine by age 23 months were adjusted for race/ethnicity.

RESULTS: The unadjusted risk of receipt of a first influenza vaccine dose was significantly higher for all non-September births compared to September births (all p < 0.001). The risk of receipt of a first dose rose from October through April before falling in May and continuing to decline through August. The trend of the relationship between birth month and receipt of a first dose of influenza vaccine was consistent across all race/ethnicity groups.

CONCLUSIONS: Children born in March-April are eligible for influenza vaccine for more person-months during the peak immunization months compared to those born in August-October. Additional late-season immunization is required to offer more vaccination opportunities to children born in fall months.

Table of Contents

CHAPTER I: BACKGROUND 1

• The Influenza Virus and Influenza Disease 1
• U.S. Burden of Influenza in Young Children 1
• Challenges in Availability and Administration of Seasonal Influenza Vaccine 1
• The Need to Prime the Infant Immune System, the Two-Dose Influenza Vaccine Recommendation, and Trends in Compliance 3
• Immunization Information Systems 4

CHAPTER II: MANUSCRIPT 5

• Introduction 5
• Methods 6
• Results 9
• Discussion 12
• Figures and Tables 16
• Supplementary Figures and Tables 28
• Appendices 31

CHAPTER III: PUBLIC HEALTH IMPLICATIONS 34
References 35

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Parola chiave	vaccines Immunization Information Systems pediatrics vaccine-preventable diseases birth month immunization infants influenza
Committee Chair / Thesis Advisor	Omer, Saad B, Emory University
Committee Members	Bednarczyk, Robert A, Emory University
Partnering Agencies	State or local health department (not in Georgia)

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