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Characterization of Heterogeneity in Childhood Immunization Coverage in Central Florida Using Immunization Registry Data

机译：使用免疫登记数据表征佛罗里达州中部儿童免疫覆盖率的异质性

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Despite high vaccine coverage in the United States in general, and in the State of Florida specifically, some children miss scheduled vaccines due to health system failures or vaccine refusal by their parents. Recent experiences with outbreaks in the United States suggest that geographic clustering of un(der)vaccinated populations represent a threat to the elimination status of some vaccine-preventable diseases. Immunization registries continue to expand and play an important role in efforts to track vaccine coverage and use. Using nearly 700,000 de-identified immunization records from the Florida Department of Health immunization information system (Florida SHOTS) for children born during 2003-2014, we explored heterogeneity and potential clustering of un(der)vaccinated children in six counties in central FloridaBrevard, Lake, Orange, Oseola, Polk, and Seminolethat represent a high-risk area for importation due to family tourist attractions in the area. By zip code, we mapped the population density, the percent of children with religious exemptions, the percent of children on track or overdue for each vaccine series without and with exemptions, and the numbers of children with no recorded dose of each vaccine. Overall, we found some heterogeneity in coverage among the counties and zip codes, but relatively consistent and high coverage. We found that some children with an exemption in the system received the vaccines we analyzed, but exemption represents a clear risk factor for un(der)immunization. We identified many challenges associated with using immunization registry data for spatial analysis and potential opportunities to improve registries to better support future analyses.
机译：尽管总体上在美国，尤其是在佛罗里达州，疫苗覆盖率很高，但由于健康系统故障或父母拒绝接受疫苗，一些儿童错过了计划接种的疫苗。美国最近爆发的经验表明，未接种疫苗的人群的地理集群对某些疫苗可预防疾病的消灭状况构成了威胁。免疫登记簿继续扩大，并在跟踪疫苗覆盖和使用的努力中发挥重要作用。利用佛罗里达卫生部免疫信息系统（Florida SHOTS）对2003-2014年出生的儿童的近700,000份身份不明的免疫记录，我们研究了佛罗里达州中部佛罗里达州六个县未接种疫苗的儿童的异质性和潜在聚类，奥兰治，奥索拉，波克和塞米诺尔地区是高风险进口地区，因为该地区有家庭旅游胜地。通过邮政编码，我们绘制了人口密度，宗教豁免儿童的百分比，每种有和没有豁免的疫苗系列的正常或过期儿童的百分比，以及未记录每种疫苗剂量的儿童的数量。总体而言，我们发现各县和邮政编码之间的覆盖范围有些不同，但相对一致且覆盖率很高。我们发现，系统中有豁免的某些儿童接种了我们分析过的疫苗，但是豁免代表了未（欠）免疫接种的明显危险因素。我们确定了与使用免疫登记数据进行空间分析相关的许多挑战，以及改进登记以更好地支持未来分析的潜在机会。

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