Association between acculturation and childhood vaccination coverage in migrant populations: a population based study from a rural region in Bavaria, Germany

OBJECTIVES: The aim of our analysis was to investigate the association between acculturation and the vaccination coverage among pre-school children.

METHODS: We performed a study of vaccination status for measles-mumps-rubella and hepatitis B among pre-school children, during mandatory school entry examinations, in a district of Bavaria, Germany, in 2004 and 2005 (N = 2,043). Prior to the examinations, parents were asked to fill out a self-administered questionnaire assessing socio-demographic information, including variables related to migration background (response rate 73%, N = 1,481). We used Categorical Principal Component Analysis (CATPCA) to create an acculturation index and assessed the association between the acculturation and vaccination status for both vaccines.

RESULTS: We found no difference in vaccination status with the measles-mumps-rubella vaccine in relation to acculturation. The coverage with at least three doses of hepatitis B vaccine was similar among migrants and in the indigenous population, but the risk of incomplete (1 or 2 doses) versus full vaccination was higher (OR = 2.74, 95% CI 1.34-5.61) and the risk of lacking vaccination lower (OR = 0.30, 95% CI 0.12-0.77) among less acculturated migrants compared to the indigenous population.

CONCLUSIONS: For multi-dose vaccines lower acculturation was associated with incomplete vaccination, but the partial protection in this group was higher compared to indigenous population.