Analysis of Research Results

Looking at Figure 1, Total Coverage: DTP, MMR,POL, and HBV, adolescents at Hasbro seem to have a low percentage of children enrolled who actually had the required number of scheduled vaccinations ’Äì only 41%.  Forty-six percent of the children are underimmunized and the vaccine status for 13% of the patients is unknown. The percentage for Rhode Island as a state was 86.3% showing that our study population has a significantly lower vaccination rate than the rest of the state and the nation (79.2%). Likewise in Figure 2, though rates are much higher when HBV is excluded, 64%, indicating an important piece of data about HBV vaccination rates, Hasbro adolescents still have vaccination rates significantly lower than statewide rates (87.3%).

Though the vaccination rates for Rhode Island are only for children aged 19-35 months and a comparison population of adolescent coverage rates in Rhode Island is necessary in order to make a true comparison, some kind of comparison number provides a context in which to place our data for the time being.

Figures 3 and 4 depict percentages of adolescents who are immunized for HIB and Varicella, respectively.  Rates are 0% for HIB and only 22% forVaricella.  These are extremely low rates and appear at first to indicate a glaring negligence. However, HIB is generally given when an infant is 8-15 months because this is the only time when it is effective. This requirement only came about after our study population had grown older than that age bracket.  Thus the fact that none of our study population were documented as vaccinated makes sense.

Very few children are documented as having been vaccinated with Varicella or having had chicken pox, only 28%. If a child has chicken pox, clearly he or she will not need vaccination.  However, because so few records document if and when a child contracts chicken pox, our study population again appears underimmunized when this is not the case. In this case 78% of our study population appears underimmunized or not having had the disease when the case is that the records did not carry the information. Of course, the fact that this many patients do not have complete records/did not contract chicken pox may indicate that records are not being kept carefully enough for a disease which can be extremely harmful if contracted after adolescence.

DTP coverage shown on Figure 5 is better than the total coverage, at 69%. When compared with state rates (19-35 month old infants) of 90.1%, Hasbro shows underimmunization.  MMR coverage again exceeds that of the total coverage rates, at 74% of children having the required number.  Though the data on state rates for comparison is not available, it may be safe to assume that again our population shows a greater number of children without the required vaccines. 

OPV/IPV coverage in Figure 7 also surpasses total coverage rates at 77% having the required number of immunizations.  However when compared again to the 19-35 month old children in the state, 96.2%,  polio coverage lags behind.  However in these adolescents, MMR, OPV/IPV and DTP seem to be the most consistently and completely administered vaccines.  The striking comparison of HBV coverage in Figure 8, on the other hand, shows Hepatitis B vaccination rates at 53%, below the state rate of 88.8%, and well below the percentages for the other vaccines. 

Hepatitis B only became free in Rhode Island in 1991. Starting then all infants began receiving it as more of a matter of course.  However, children born between 1982 and 1986 were targeted as needing vaccination only then, causing a mobilization to vaccinate adolescents and older children who were likely visiting the hospital much less often than their infant counterparts.  Low vaccination rates for our study population may be explained by the fact that generally speaking doctors see an individual adolescent less often than an infant, making vaccine follow-up much more difficult.

Figure 9 clearly demonstrates the coverage differences between the vaccines, how DTP, MMR, and OPV/IPV vaccination is covered more completely on the whole in this population compared to HBV.  Again because HIB and Varicella have exceptional cases the fact that coverage is so much lower in those two must be viewed with a perspective on the specific situations.

Figures 10 and 11 compare the total coverage rates of different race populations at Hasbro. In Figure 10, when HBV is included, White, Black, Hispanic and ’Äúother’Äù children have comparatively similar rates, all low, between 41 and 49%.  The Asian population is too small, only 3 children, to use the data from this group in our analysis.  In Figure 11 without HBV, each population shows about a 25% rise in coverage. However, especially in Figure 11, the Black population has a significantly lower coverage rate. This trend is evident throughout the following figures of each individual vaccine, indicating that immunization access, follow-up, financial situations and other aspects of Black adolescent health care may need study in order to assure these children full coverage and health.

DTP coverage in Figure 12 shows that about 77% of White, Hispanic and ’Äúother’Äù children have the required number of vaccines, whereas Black children are only at 70%.  Similarly MMR coverage in Figure 13  in White and Hispanic children is about 82%, 86.25% in ’Äúother’Äù children, and only 71.11% in Black children. This is a large difference in coverage rates similar to the trend in DTP, where White, Hispanic and ’Äúother’Äù children are more completely covered than Black.  OPV/IPV coverage rates in Figure 14 repeat this trend though not as strikingly as DTP or MMR.  Approximately 81% of White children and 78% of Hispanic and ’Äúother’Äù children have the required number of vaccines  while only 75.56% of Black children do.  This figure may also indicate that a higher percentage of White children have the required number of polio vaccines than any other group.  Again, such results warrant further study as to how to bring each child, no matter race or socioeconomic background to the same level of health.

Finally in Figure 15, HBV shows a similar trend as the other vaccines except without such a large difference between White and Black patients, but with a characteristically higher percentage of Hispanic and ’Äùother’Äù children having the required number of  vaccinations.