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Vital Signs

Immunization Disparities Gap Finally Starting to Close

Does it sometimes seem to you that despite years of efforts to eliminate racial and ethnic health disparities very little progress is being made? Then here’s some encouraging news. The results of a study by the Centers for Disease Control and Prevention (CDC) published earlier this year reveal that there may finally be some light at the end of the tunnel when it comes to reducing at least one key minority health disparity: higher rates of pneumonia and meningitis in African-American children than in their Caucasian counterparts.

The study found that the introduction of the childhood vaccine Prevnar®, which was approved in 2000 for use in the U.S., has already begun to make a significant difference in improving the health of black children in just a few short years. Before the vaccine became available, incidence of pneumonia and meningitis infections in African-American children younger than age two was 3.3 times higher than for white children. By 2002, the gap had narrowed to only 1.6 times higher.

Furthermore, between 1998 and 2002 the annual U.S. incidence of pneumonia and meningitis decreased from 19 to 12.1 cases per 100,000 among whites and from 54.9 to 26.5 cases per 100,000 among African-Americans—a dramatic improvement that the CDC again attributes to the Prevnar vaccine. “Due to these declines,” the study notes, “14,730 fewer cases occurred among whites and 8,780 fewer cases occurred among blacks in the U.S. in 2002, compared with the average number in two pre-vaccine years, 1998 and 1999.”

The report, published in the May 12 issue of the Journal of the American Medical Association, strongly suggests that these results are at least partially due to efforts to reduce racial disparities in immunization levels. Because Prevnar works well in patients of all races, the study’s authors argue, the improvement in the U.S. black versus white rate probably reflects the fact that some black children were targeted for the immunization. The CDC also recommends targeting Prevnar vaccinations to Native American children living in Alaska, Arizona or New Mexico, and to Navajo children in Utah and Colorado, all of whom have a pneumonia/meningitis risk more than twice the national average.