科研之友
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摘要
Background: Introduction of new private, voluntary immunizations often results in low vaccine uptake among certain sub-groups within the population. Revealing factors associated with underimmunization is crucial in vaccine endorsement and distribution. %26lt;br%26gt;Objective: Our goal was to investigate the effect of child%26apos;s birth order on private voluntary varicella vaccination. %26lt;br%26gt;Methods: A nested case-control study was conducted on a cohort of 110,902 Israeli children under the age of 5 years. We compared social and demographic factors of immunized and unimmunized participants. Logistic regression models were built to examine the association between birth order and vaccination, controlling for child%26apos;s age, gender, country of birth, ethnicity, parents%26apos; country of birth, area of residence, and socioeconomic status (SES). %26lt;br%26gt;Results: Ethnicity had the highest association with varicella immunization status. The odds of vaccination in the general Jewish and Ultra-Orthodox Jewish populations were 25.55-(95%CI:20.13;32.42) and 15.04-(95%CI:10.18;22.22) times the odds in Arab population, respectively. Child%26apos;s birth order was inversely related to vaccination status and presented a nonlinear exposure-response relationship. This relationship was maintained in different ethnicity and SES groups. Child%26apos;s birth order was associated with vaccination differently in large (%26gt;3 siblings) and small to average-sized sibships (%26lt;= 3 siblings). Other parameters associated with vaccination were child%26apos;s and parents%26apos; country of origin, area of residence and SES. %26lt;br%26gt;Conclusions: Birth order is an independent risk factor for underimmunization, associated with child%26apos;s vaccination status beyond economic, social, and demographic parental characteristics.
- 出版日期2012-1-5
