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Vaccination is broadly accepted as among the most successful global public health interventions. In most developed countries, the coverage rates of childhood vaccination are moderately high. Yet, in several instances, immunization rates remain below the aspired targets and have shown modest progress toward the said targets in the past few years. This is despite concerted efforts that have been taken to enhance uptake. To some extent, rates of coverage are a reflection of the individual parent’s attitudes toward vaccination and their decisions as well. Because the decision-making in vaccination is context-specific and complex, it remains a challenge at both the community and individual levels when it comes to assisting parents in making positive decisions (Chung et al., 2017). Initiatives such as those listed in the ‘Close the Immunization Gap’ by WHO can be used to mitigate these disparities. A simple initiative, for example, the recall and reminder system, can offer parents prompts when vaccination dates are due and thus, remind parents that their physicians view vaccination as an important way of maintaining and safeguarding their children’s health. These interactions can raise discussion opportunities with parents as regards their decision-making (Thakkar & Sanghvi, 2016).

A periodic review of levels of coverage at a healthcare practitioner’s level or even a broader geographical level can inform public health agencies and providers on the need for targeted efforts and initiatives, with a broader focus, as population groups or areas with declining or low coverage is identified. Routine coverage data can be used in targeting efforts on immunization rates improvement, implementation of vaccination promotion through pre-calls, as well as reminder programs for parents. Nonetheless, further research is needed to eliminate the interplay between several factors within the public health policy, community attitudes, service delivery, interpersonal and intrapersonal domains that influence parents’ decisions regarding immunizations (Corben & Leask, 2016).


Chung, Y., Schamel, J., Fisher, A., & Frew, P. M. (2017). Influences on immunization decision-making among US parents of young children. Maternal and child health journal21(12), 2178-2187.

Corben, P., & Leask, J. (2016). To close the childhood immunization gap, we need a richer understanding of parents’ decision-making. Human vaccines & immunotherapeutics12(12), 3168-3176.

Thakkar, P., & Sanghvi, N. (2016). How Close are we to Close the Immunization Gap?. Indian pediatrics53(4), 354.


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Preventing childhood illness from the use of vaccines is a proven method of reduction in mortality and morbidity. According to Healthy People 2020 the highest majority of children who do not receive their vaccines are of those families who are <100% below the poverty line (Healthy People
In a recent study it was found that:
For most vaccines, 2016 coverage was lower among non-Hispanic black (black) children than among non-Hispanic white (white) children, and for children living below the federal poverty level compared with those living at or above the poverty level. Vaccination coverage was generally lower among children insured by Medicaid (2.5–12.0 percentage points), and was much lower among uninsured children (12.4–24.9 percentage points), than among children with private insurance (Hill, et al 2017).
This shows a disparity among children that are under varying insurance policies/plans or those that are uninsured. Children are too young to be able to speak for themselves and need to have adults advocate for them. Again due to their age and mentality they are not able to determine what is the best course of action for them in regards to vaccines, and if their parents/guardians are up against a difficult time and are not in a good financial or medical state the child should not have to go unvaccinated.
Noted disparities do indicate that there are some improvements that could possibly be taken to help close the gap amongst children, despite ethnic background or their insurance coverage-ability. In the long run the cost to cover the vaccines would significantly be less expensive than covering a hospital illness from a preventable disease.


Healthy people 2020. (n.d.). Retrieved March 18, 2021, from

Hill, H. A., Elam-Evans, L. D., Yankey, D., Singleton, J. A., & Kang, Y. (2017). Vaccination Coverage Among Children Aged 19-35 Months – United States, 2016. MMWR. Morbidity and mortality weekly report, 66(43), 1171–1177.


Initial Discussion Prompt



Examine Healthy People 2020 health promotion and disease prevention objectives. Identify a health disparity and research this topic, how is it being addressed at both the local and national level.


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