Preventable Disease, the Case of Colorado: School District Demographics and Childhood Immunizations
Abstract
:1. Introduction
2. Materials and Methods
2.1. Vaccination Status and Demographic Factor Data
2.2. Statistical Analysis
3. Results
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Connolly, M.A.; Gayer, M.; Ryan, M.J.; Salama, P.; Spiegel, P.; Heymann, D.L. Communicable diseases in complex emergencies: Impact and challenges. Lancet 2004, 364, 1974–1983. [Google Scholar] [CrossRef]
- DeSilva, M.B.; Haapala, J.; Vazquez-Benitez, G.; Daley, M.F.; Nordin, J.D.; Klein, N.P.; Henninger, M.L.; Williams, J.T.; Hambidge, S.J.; Jackson, M.L.; et al. Association of the COVID-19 Pandemic With Routine Childhood Vaccination Rates and Proportion Up to Date With Vaccinations Across 8 US Health Systems in the Vaccine Safety Datalink. JAMA Pediatr. 2022, 176, 68–77. [Google Scholar] [CrossRef]
- Murthy, B.P.; Zell, E.; Kirtland, K.; Jones-Jack, N.; Harris, L.; Sprague, C.; Schultz, J.; Le, Q.; Bramer, C.A.; Kuramoto, S.; et al. Impact of the COVID-19 Pandemic on Administration of Selected Routine Childhood and Adolescent Vaccinations—10 US Jurisdictions, March–September 2020. Morb. Mortal. Wkly. Rep. 2021, 70, 840. [Google Scholar] [CrossRef] [PubMed]
- Cataldi, J.R.; Armon, C.; Beeson, A.; Asturias, E.J.; Todd, J.K. Contagious Comments The Vaccine-Preventable Diseases Report; Aurora, CO, USA, 2021. Available online: https://www.immunizecolorado.org/wp-content/uploads/2021/10/Vaccine-Preventable-Diseases-April-2021_FINAL.pdf (accessed on 12 September 2022).
- MacDonald, N.E. Vaccine hesitancy: Definition, scope and determinants. Vaccine 2015, 33, 4161–4164. [Google Scholar] [CrossRef] [PubMed]
- Phadke, V.K.; Bednarczyk, R.A.; Salmon, D.A.; Omer, S.B. Association between vaccine refusal and vaccine-preventable diseases in the United States: A review of measles and pertussis. JAMA 2016, 315, 1149–1158. [Google Scholar] [CrossRef] [PubMed]
- Feikin, D.R.; Lezotte, D.C.; Hamman, R.F.; Salmon, D.A.; Chen, R.T.; Hoffman, R.E. Individual and Community Risks of Measles and Pertussis Associated With Personal Exemptions to Immunization. JAMA 2000, 284, 3145–3150. [Google Scholar] [CrossRef]
- Larson, H.J.; Jarrett, C.; Eckersberger, E.; Smith, D.M.D.; Paterson, P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012. Vaccine 2014, 32, 2150–2159. [Google Scholar] [CrossRef]
- Santibanez, T.A.; Nguyen, K.H.; Greby, S.M.; Fisher, A.; Scanlon, P.; Bhatt, A.; Srivastav, A.; Singleton, J.A. Parental Vaccine Hesitancy and Childhood Influenza Vaccination. Pediatrics 2020, 146, e2020007609. [Google Scholar] [CrossRef] [PubMed]
- Charron, J.; Gautier, A.; Jestin, C. Influence of information sources on vaccine hesitancy and practices. Med. Mal. Infect. 2020, 50, 727–733. [Google Scholar] [CrossRef]
- Mukherjee, S.; Madhivanan, P.; Li, T.; Albatineh, A.; Srinivas, V.; Jaykrishna, P.; Arun, A.; Krupp, K. Correlates of completing routine vaccination among children in Mysore, India. J. Infect. Public Health 2015, 8, 62–71. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Geelen, E.; van Vliet, H.; de Hoogh, P.; Horstman, K. Taming the fear of voice: Dilemmas in maintaining a high vaccination rate in the Netherlands. Soc. Sci. Med. 2016, 153, 12–19. [Google Scholar] [CrossRef] [PubMed]
- Torun, S.D.; Bakirci, N. Vaccination coverage and reasons for non-vaccination in a district of Istanbul. BMC Public Health 2006, 6, 125. [Google Scholar] [CrossRef] [PubMed]
- Blank, P.R.; Schwenkglenks, M.; Szucs, T.D. Vaccination coverage rates in eleven European countries during two consecutive influenza seasons. J. Infect. 2009, 58, 446–458. [Google Scholar] [CrossRef] [PubMed]
- Quinn, S.; Jamison, A.; Musa, D.; Hilyard, K.; Freimuth, V. Exploring the Continuum of Vaccine Hesitancy Between African American and White Adults: Results of a Qualitative Study. PLoS Curr. 2016, 8, ecurrents.outbreaks.3e4a5ea39d8620494e2a2c874a3c42. [Google Scholar] [CrossRef]
- Dudley, M.Z.; Limaye, R.J.; Salmon, D.A.; Omer, S.B.; O’Leary, S.T.; Ellingson, M.K.; Spina, C.I.; Brewer, S.E.; Bednarczyk, R.A.; Malik, F.; et al. Racial/Ethnic Disparities in Maternal Vaccine Knowledge, Attitudes, and Intentions. Public Health Rep. 2021, 136, 699–709. [Google Scholar] [CrossRef] [PubMed]
- Nowak, G.J.; Cacciatore, M.A. Parents’ confidence in recommended childhood vaccinations: Extending the assessment, expanding the context. Hum. Vaccines Immunother. 2017, 13, 687–700. [Google Scholar] [CrossRef] [PubMed]
- Jamison, A.M.; Quinn, S.C.; Freimuth, V.S. “You don’t trust a government vaccine”: Narratives of institutional trust and influenza vaccination among African American and white adults. Soc. Sci. Med. 2019, 221, 87–94. [Google Scholar] [CrossRef]
- O’Leary, S.T.; Trefren, L.; Roth, H.; Moss, A.; Severson, R.; Kempe, A. Number of Childhood and Adolescent Vaccinations Administered Before and After the COVID-19 Outbreak in Colorado. JAMA Pediatr. 2021, 175, 305–307. [Google Scholar] [CrossRef]
- Aw, J.; Seng, J.J.; Seah, S.S.; Low, L.L. COVID-19 Vaccine Hesitancy—A Scoping Review of Literature in High-Income Countries. Vaccines 2021, 9, 900. [Google Scholar] [CrossRef]
- Colorado Department of Public Health and the Environment. Disease Control and Public Health Response Portal. 2021. Available online: https://www.dcphrapps.dphe.state.co.us/Reports/ReportList/Partners (accessed on 12 January 2022).
- Colorado Department of Education. Pupil Membership. 2021. Available online: https://www.cde.state.co.us/cdereval/pupilcurrent (accessed on 12 January 2022).
- Colorado Department of Education. Income Eligibility Guidelines. 2022; p. 1. Available online: https://www.cde.state.co.us/nutrition/22-23ieg (accessed on 1 September 2022).
- Zipfel, C.M.; Garnier, R.; Kuney, M.C.; Bansal, S. The landscape of childhood vaccine exemptions in the United States. Sci. Data 2020, 7, 401. [Google Scholar] [CrossRef]
- Berkessel, J.B.; Gebauer, J.E.; Joshanloo, M.; Bleidorn, W.; Rentfrow, P.J.; Potter, J.; Gosling, S.D. National religiosity eases the psychological burden of poverty. Proc. Natl. Acad. Sci. USA 2021, 118, e2103913118. [Google Scholar] [CrossRef]
- Sandstrom, A. Amid Measles Outbreak, New York Closes Religious Exemption for Vaccinations—But Most States Retain It; Pew Research Center: Washington, DC, USA, 2019; Available online: https://www.pewresearch.org/fact-tank/2019/06/28/nearly-all-states-allow-religious-exemptions-for-vaccinations/ (accessed on 29 January 2022).
- Shaw, J.; Mader, E.M.; Bennett, B.E.; Vernyi-Kellogg, O.K.; Yang, Y.T.; Morley, C.P. Immunization Mandates, Vaccination Coverage, and Exemption Rates in the United States. Open Forum Infect. Dis. 2018, 5, ofy130. [Google Scholar] [CrossRef] [PubMed]
- Omer, S.B.; Porter, R.M.; Allen, K.; Salmon, D.A.; Bednarczyk, R.A. Trends in Kindergarten Rates of Vaccine Exemption and State-Level Policy, 2011–2016. Open Forum Infect. Dis. 2018, 5, ofx244. [Google Scholar] [CrossRef] [PubMed]
- Paquette, E.T. In the Wake of a Pandemic: Revisiting School Approaches to Nonmedical Exemptions to Mandatory Vaccination in the US. J. Pediatr. 2021, 231, 17–23. [Google Scholar] [CrossRef]
- Garnier, R.; Nedell, E.R.; Omer, S.B.; Bansal, S. Getting Personal: How Childhood Vaccination Policies Shape the Landscape of Vaccine Exemptions. Open Forum Infect. Dis. 2020, 7, ofaa088. [Google Scholar] [CrossRef]
- Smith, P.J.; Chu, S.Y.; Barker, L.E. Children Who Have Received No Vaccines: Who Are They and Where Do They Live? Pediatrics 2004, 114, 187–195. [Google Scholar] [CrossRef] [PubMed]
- Shui, I.M.; Weintraub, E.S.; Gust, D.A. Parents Concerned About Vaccine Safety. Am. J. Prev. Med. 2006, 31, 244–251. [Google Scholar] [CrossRef] [PubMed]
- Gust, D.; Woodruff, R.; Kennedy, A.; Brown, C.; Sheedy, K.; Hibbs, B. Parental perceptions surrounding risks and benefits of immunization. Semin. Pediatr. Infect. Dis. 2003, 14, 207–212. [Google Scholar] [CrossRef]
- Kempe, A.; Saville, A.W.; Albertin, C.; Zimet, G.; Breck, A.; Helmkamp, L.; Vangala, S.; Dickinson, L.M.; Rand, C.; Humiston, S.; et al. Parental Hesitancy About Routine Childhood and Influenza Vaccinations: A National Survey. Pediatrics 2020, 146, e20193852. [Google Scholar] [CrossRef]
- Smith, P.J.; Humiston, S.G.; Marcuse, E.K.; Zhao, Z.; Dorell, C.G.; Howes, C.; Hibbs, B. Parental Delay or Refusal of Vaccine Doses, Childhood Vaccination Coverage at 24 Months of Age, and the Health Belief Model. Public Health Rep. 2011, 126, 135–146. [Google Scholar] [CrossRef] [Green Version]
- Gilkey, M.B.; McRee, A.-L.; Brewer, N.T. Forgone vaccination during childhood and adolescence: Findings of a statewide survey of parents. Prev. Med. 2013, 56, 202–206. [Google Scholar] [CrossRef]
- Opel, D.J.; Taylor, J.A.; Mangione-Smith, R.; Solomon, C.; Zhao, C.; Catz, S.; Martin, D. Validity and reliability of a survey to identify vaccine-hesitant parents. Vaccine 2011, 29, 6598–6605. [Google Scholar] [CrossRef] [PubMed]
- Reich, J.A. Neoliberal Mothering and Vaccine Refusal: Imagined Gated Communities and the Privilege of Choice. Gend. Soc. 2014, 28, 679–704. [Google Scholar] [CrossRef]
- Roberts, H.A.; Clark, D.A.; Kalina, C.; Sherman, C.; Brislin, S.; Heitzeg, M.M.; Hicks, B.M. To vax or not to vax: Predictors of anti-vax attitudes and COVID-19 vaccine hesitancy prior to widespread vaccine availability. PLoS ONE 2022, 17, e0264019. [Google Scholar] [CrossRef] [PubMed]
- Wagner, A.L.; Masters, N.B.; Domek, G.J.; Mathew, J.L.; Sun, X.; Asturias, E.J.; Ren, J.; Huang, Z.; Contreras-Roldan, I.L.; Gebremeskel, B.; et al. Comparisons of Vaccine Hesitancy across Five Low- and Middle-Income Countries. Vaccines 2019, 7, 155. [Google Scholar] [CrossRef]
- Hegde, S.T.; Wagner, A.L.; Clarke, P.J.; Potter, R.C.; Swanson, R.G.; Boulton, M.L. Neighbourhood influence on the fourth dose of diphtheria-tetanus-pertussis vaccination. Public Health 2019, 167, 41–49. [Google Scholar] [CrossRef] [PubMed]
- Freed, G.L.; Clark, S.J.; Butchart, A.T.; Singer, D.C.; Davis, M.M. Parental Vaccine Safety Concerns in 2009. Pediatrics 2010, 125, 654–659. [Google Scholar] [CrossRef]
- He, K.; Mack, W.J.; Neely, M.; Lewis, L.; Anand, V. Parental Perspectives on Immunizations: Impact of the COVID-19 Pandemic on Childhood Vaccine Hesitancy. J. Community Health 2021, 47, 39–52. [Google Scholar] [CrossRef]
- Bryden, G.M.; Browne, M.; Rockloff, M.; Unsworth, C. The privilege paradox: Geographic areas with highest socio-economic advantage have the lowest rates of vaccination. Vaccine 2019, 37, 4525–4532. [Google Scholar] [CrossRef]
- Yang, Y.T.; Delamater, P.L.; Leslie, T.F.; Mello, M.M. Sociodemographic Predictors of Vaccination Exemptions on the Basis of Personal Belief in California. Am. J. Public Health 2016, 106, 172–177. [Google Scholar] [CrossRef]
- Bianco, A.; Mascaro, V.; Zucco, R.; Pavia, M. Parent perspectives on childhood vaccination: How to deal with vaccine hesitancy and refusal? Vaccine 2019, 37, 984–990. [Google Scholar] [CrossRef] [PubMed]
- US Census Bureau. About the Topic of Race. The U.S. Census Bureau Must Adhere to the Any of the Black Racial Groups of Africa. 2022. Available online: https://www.census.gov/topics/population/race/about.html (accessed on 1 September 2022).
- Hardt, K.; Schmidt-Ott, R.; Glismann, S.; Adegbola, R.A.; Meurice, F.P. Sustaining Vaccine Confidence in the 21st Century. Vaccines 2013, 1, 204–224. [Google Scholar] [CrossRef] [PubMed]
- Lin, C.; Parker, T.; Pejavara, K.; Smith, D.; Tu, R.; Tu, P. “I Would Never Push a Vaccine on You”: A Qualitative Study of Social Norms and Pressure in Vaccine Behavior in the U.S. Vaccines 2022, 10, 1402. [Google Scholar] [CrossRef]
- Attwell, K.; Navin, M.C.; Lopalco, P.L.; Jestin, C.; Reiter, S.; Omer, S.B. Recent vaccine mandates in the United States, Europe and Australia: A comparative study. Vaccine 2018, 36, 7377–7384. [Google Scholar] [CrossRef]
- Gostin, L.O.; DeAngelis, C.D. Mandatory HPV Vaccination Public Health vs Private Wealth. JAMA 2007, 297, 1921–1923. [Google Scholar] [CrossRef] [PubMed]
- Reczulska, A.; Tomaszewska, A.; Raciborski, F. Level of Acceptance of Mandatory Vaccination and Legal Sanctions for Refusing Mandatory Vaccination of Children. Vaccines 2022, 10, 811. [Google Scholar] [CrossRef] [PubMed]
- Peruch, M.; Toscani, P.; Grassi, N.; Zamagni, G.; Monasta, L.; Radaelli, D.; Livieri, T.; Manfredi, A.; D’Errico, S. Did Italy Really Need Compulsory Vaccination against COVID-19 for Healthcare Workers? Results of a Survey in a Centre for Maternal and Child Health. Vaccines 2022, 10, 1293. [Google Scholar] [CrossRef] [PubMed]
- Slotte, P.; Karlsson, L.C.; Soveri, A. Attitudes towards mandatory vaccination and sanctions for vaccination refusal. Vaccine, 2022; in press. [Google Scholar] [CrossRef]
Variable | Mean | Std Dev | Minimum | Maximum | |
---|---|---|---|---|---|
School Population | 4411.74 | 11,575.23 | 12 | 85,202 | |
Number of Facilities | 9.28 | 22.26 | 1 | 198 | |
Poverty | Free Meal % | 36.7% | 16.6% | 1.6% | 91.2% |
Reduced Meal % | 9.8% | 4.7% | 0.9% | 31.6% | |
Free & Reduced Meal % | 46.3% | 18.5% | 2.1% | 96.6% | |
Race | Native American % | 1.0% | 3.0% | 0.0% | 31.9% |
Asian % | 0.9% | 1.3% | 0.0% | 9.0% | |
Black % | 1.5% | 2.7% | 0.0% | 22.1% | |
Hispanic % | 29.1% | 21.0% | 0.0% | 95.7% | |
White Alone % | 64.6% | 21.7% | 3.3% | 100.0% | |
Pacific Islander % | 0.2% | 0.3% | 0.0% | 2.9% | |
Multiracial % | 2.7% | 2.3% | 0.0% | 15.2% |
Variable | Fully Immunized % | In Process % | Incomplete Record % | Medical Exemption % | No Record % | Personal Exemption % | Religious Exemption % | Compliant For All % | |
---|---|---|---|---|---|---|---|---|---|
Free Meal % | Estimate | 0.035 | 0.003 | 0.007 | 0.002 | −0.001 | −0.056 | 0.010 | 0.018 |
Std Error | 0.013 | 0.004 | 0.008 | 0.001 | 0.004 | 0.007 | 0.001 | 0.014 | |
p-Value | 0.0071 * | 0.4494 | 0.3767 | 0.0199 * | 0.8350 | 3.8 × 10−14 ** | 2.5 × 10−12 ** | 0.1936 | |
Reduced Meal % | Estimate | −0.016 | −0.030 | 0.020 | −0.005 | 0.012 | 0.004 | 0.026 | −0.021 |
Std Error | 0.026 | 0.011 | 0.018 | 0.002 | 0.010 | 0.015 | 0.003 | 0.027 | |
p-Value | 0.5544 | 0.0048 * | 0.2473 | 0.0274 * | 0.2371 | 0.8135 | 2.7 × 10−15 ** | 0.4407 | |
Free & Reduced Meal % | Estimate | 0.017 | 0.000 | 0.008 | 0.001 | 0.002 | −0.039 | 0.013 | 0.006 |
Std Error | 0.011 | 0.004 | 0.007 | 0.001 | 0.005 | 0.006 | 0.001 | 0.012 | |
p-Value | 0.1350 | 0.9794 | 0.2331 | 0.1780 | 0.6074 | 1.9 × 10−9 ** | 1.3 × 10−24 ** | 0.5950 |
Variable | Fully Immunized % | In Process % | Incomplete Record % | Medical Exemption % | No Record % | Personal Exemption % | Religious Exemption % | Compliant For All % | |
---|---|---|---|---|---|---|---|---|---|
Native American % | Estimate | −0.306 | −0.006 | −0.090 | −0.006 | −0.008 | 0.438 | 0.033 | 0.276 |
Std Error | 0.108 | 0.025 | 0.053 | 0.005 | 0.035 | 0.065 | 0.011 | 0.120 | |
p-Value | 0.0047 * | 0.8246 | 0.0940 | 0.2438 | 0.8246 | 1.6 × 10−11 ** | 0.0018 * | 0.0214 * | |
Asian % | Estimate | −0.264 | −0.038 | 0.221 | 0.020 | −0.012 | 0.045 | 0.067 | 0.034 |
Std Error | 0.216 | 0.066 | 0.122 | 0.013 | 0.083 | 0.123 | 0.024 | 0.223 | |
p-Value | 0.2208 | 0.5690 | 0.0702 | 0.1382 | 0.8848 | 0.7135 | 0.0053 * | 0.8794 | |
Black % | Estimate | 0.068 | −0.035 | −0.037 | 0.003 | 0.007 | 0.110 | 0.037 | 0.553 |
Std Error | 0.081 | 0.027 | 0.048 | 0.005 | 0.033 | 0.046 | 0.009 | 0.081 | |
p-Value | 0.4040 | 0.1949 | 0.4454 | 0.6167 | 0.8314 | 0.0163 * | 8.1 × 10−5 ** | 1.3 × 10−11 ** | |
Hispanic % | Estimate | 0.120 | −0.006 | 0.004 | 0.001 | −0.007 | −0.094 | −0.005 | −0.002 |
Std Error | 0.015 | 0.004 | 0.008 | 0.001 | 0.005 | 0.009 | 0.002 | 0.018 | |
p-Value | 5.5 × 10−15 ** | 0.0942 | 0.5765 | 0.2292 | 0.1368 | 1.7 × 10−26 ** | 0.0019 * | 0.9152 | |
White Alone % | Estimate | −0.094 | 0.005 | −0.002 | −0.001 | 0.008 | 0.063 | 0.004 | −0.046 |
Std Error | 0.015 | 0.004 | 0.008 | 0.001 | 0.005 | 0.009 | 0.002 | 0.018 | |
p-Value | 9.9 × 10−10 ** | 0.1885 | 0.8022 | 0.1330 | 0.0941 | 8.3 × 10−13 ** | 0.0240 * | 0.0105 * | |
Pacific Islander % | Estimate | 0.646 | −0.361 | 0.782 | 0.062 | 0.354 | −1.126 | −0.008 | −3.916 |
Std Error | 0.485 | 0.185 | 0.301 | 0.038 | 0.212 | 0.269 | 0.057 | 0.472 | |
p-Value | 0.1826 | 0.0513 | 0.0093 * | 0.0998 | 0.0953 | 2.9 × 10−5 ** | 0.8868 | 1.4 × 10−16 ** | |
Multiracial % | Estimate | −0.671 | 0.149 | −0.044 | 0.015 | −0.054 | 0.595 | −0.028 | 0.492 |
Std Error | 0.085 | 0.029 | 0.051 | 0.006 | 0.035 | 0.047 | 0.010 | 0.086 | |
p-Value | 3.5 × 10−15 ** | 4.0 × 10−7 ** | 0.3869 | 0.0120 * | 0.1263 | 1.8 × 10−35 ** | 0.0048 * | 1.0 × 10−8 ** |
Effect | Fully Immunized % | In Process % | Incomplete Record % | Medical Exemption % | No Record % | Personal Exemption % | Religious Exemption % | Compliant For All % |
---|---|---|---|---|---|---|---|---|
Native American % | 3.5 × 10−8 ** | 0.1445 | 0.7556 | 0.5826 | 0.4432 | 1.1 × 10−14 ** | 0.0521 | 0.3003 |
Free & Reduced meal % | 0.6856 | 0.5669 | 0.2309 | 0.2425 | 0.4199 | 0.0004 * | 2.7 × 10−23 ** | 0.5418 |
Native American % by Free & Reduced meal % interaction | 9.8 × 10−7 ** | 0.1259 | 0.8606 | 0.7483 | 0.3855 | 1.4 × 10−8 ** | 0.2421 | 0.9569 |
Asian % | 0.9915 | 0.6608 | 0.0271 * | 0.0996 | 0.4928 | 0.1177 | 0.7184 | 0.0034 * |
Free & Reduced meal % | 0.1854 | 0.8223 | 0.0435 * | 0.7448 | 0.9441 | 1.8 × 10−9 ** | 2.3 × 10−18 ** | 0.0733 |
Asian % by Free & Reduced meal % interaction | 0.9282 | 0.8151 | 0.1355 | 0.0039 * | 0.5402 | 0.2672 | 0.2632 | 0.0097 * |
Black % | 0.9052 | 0.3134 | 0.2235 | 0.2033 | 0.1359 | 0.0366 * | 0.7356 | 0.3307 |
Free & Reduced meal % | 0.2924 | 0.8403 | 0.5233 | 0.7426 | 0.2199 | 6.6 × 10−7 ** | 9.3 × 10−17 ** | 0.0993 |
Black % by Free & Reduced meal % interaction | 0.6932 | 0.5453 | 0.3374 | 0.1508 | 0.1208 | 0.2678 | 0.4144 | 0.0004 * |
Hispanic % | 4.1 × 10−9 ** | 0.7442 | 0.8217 | 0.0902 | 0.3619 | 5.0 × 10−23 ** | 0.0262 * | 0.0307 * |
Free & Reduced meal % | 0.2488 | 0.2759 | 0.3074 | 0.3917 | 0.5440 | 2.3 × 10−11 ** | 5.5 × 10−37 ** | 0.0289 * |
Hispanic % by Free & Reduced meal % interaction | 0.0245 * | 0.6258 | 0.7633 | 0.0393 * | 0.7873 | 1.6 × 10−8 ** | 1.0 × 10−9 ** | 0.0116 * |
White % | 0.0001 ** | 0.6193 | 0.7683 | 0.1310 | 0.4881 | 2.4 × 10−9 ** | 0.0052 * | 1.6 × 10−4 ** |
Free & Reduced meal % | 0.3684 | 0.8777 | 0.9300 | 0.0349 * | 0.7420 | 0.0888 | 0.0319 * | 0.0103 * |
White % by Free & Reduced meal % interaction | 0.3542 | 0.8966 | 0.5963 | 0.0459* | 0.9440 | 0.0009 * | 6.7 × 10−10 ** | 0.0064 * |
Pacific Islander % | 0.0932 | 0.8695 | 0.0027 * | 0.1028 | 0.8454 | 3.9 × 10−8 ** | 0.1447 | 1.7 × 10−7 ** |
Free & Reduced meal % | 0.0872 | 0.8400 | 0.0882 | 0.7239 | 0.8414 | 1.1 × 10−11 ** | 1.1 × 10−22 ** | 0.7747 |
Pacific Islander % by Free & Reduced meal % interaction | 0.2664 | 0.4136 | 0.0452 * | 0.0079 * | 0.2685 | 1.4 × 10−4 ** | 0.1007 | 0.2362 |
Multiracial % | 6.7 × 10−8 ** | 0.0068 * | 0.2398 | 0.0174 * | 0.3835 | 4.7 × 10−25 ** | 0.0870 | 0.1799 |
Free & Reduced meal % | 0.3619 | 0.0014 * | 0.0610 | 0.0267 * | 0.1948 | 0.6899 | 1.9 × 10−11 ** | 0.7098 |
Multiracial % by Free & Reduced meal % interaction | 0.0662 | 6.4 × 10−8 ** | 0.1055 | 0.1724 | 0.1017 | 4.2 × 10−7 ** | 0.0682 | 0.3395 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Nicolich, K.; Gerken, J.; Mallahan, B.; Ross, D.W.; Zapata, I. Preventable Disease, the Case of Colorado: School District Demographics and Childhood Immunizations. Vaccines 2022, 10, 1579. https://doi.org/10.3390/vaccines10101579
Nicolich K, Gerken J, Mallahan B, Ross DW, Zapata I. Preventable Disease, the Case of Colorado: School District Demographics and Childhood Immunizations. Vaccines. 2022; 10(10):1579. https://doi.org/10.3390/vaccines10101579
Chicago/Turabian StyleNicolich, Katherine, Jacob Gerken, Blaire Mallahan, David W. Ross, and Isain Zapata. 2022. "Preventable Disease, the Case of Colorado: School District Demographics and Childhood Immunizations" Vaccines 10, no. 10: 1579. https://doi.org/10.3390/vaccines10101579
APA StyleNicolich, K., Gerken, J., Mallahan, B., Ross, D. W., & Zapata, I. (2022). Preventable Disease, the Case of Colorado: School District Demographics and Childhood Immunizations. Vaccines, 10(10), 1579. https://doi.org/10.3390/vaccines10101579