ABSTRACT
According to Minnesota Immunization Information Connection (MIIC) data, 23% of Minnesotans were vaccinated against 2009 pandemic H1N1 influenza. We analyzed 2009 H1N1 vaccination data at the ZIP code level to learn more about who received the vaccine between 2009 and 2010. We found significant differences in H1N1 vaccination rates by percentage of residents living below the family poverty line, percentage of non-Caucasian residents in a ZIP code and median family income. When stratified by urban or rural location, median family income was significantly associated with vaccination rate only in urban settings; the percentage of non-Caucasians living in an area was significant only in rural settings. In both urban and rural settings, most H1N1 vaccinations were given in a private facility, although the proportion was much higher in urban ZIP codes (81.5%) than rural ZIP codes (53.2%, P < 0.0001). Further research is needed to find out why vaccination rates were associated with increasing median family income in urban areas and why in rural areas, people living in ZIP codes with a higher percentage of non-Caucasian residents were more likely to be vaccinated after controlling for poverty and median income.
Subject(s)
Immunization Programs/statistics & numerical data , Influenza A Virus, H1N1 Subtype , Influenza Vaccines/administration & dosage , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics/prevention & control , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Adult , Aged , Child , Child, Preschool , Humans , Infant , Middle Aged , Minnesota , Poverty Areas , Social Environment , Socioeconomic Factors , Utilization Review/statistics & numerical data , Young AdultABSTRACT
Prior to 2009, influenza pandemic planners had primarily planned for a virus that would originate in a location other than North America, giving public health officials in the United States time to determine its severity before widespread disease occurred here. Thus, response plans for schools focused on closure in the case of a severe pandemic and potential closure in the event of a moderate one. The 2009 H1N1 pandemic, however, presented a different scenario. The severity of 2009 H1N1 was initially unknown and later was determined to be mild to moderate. Thus, as the pandemic unfolded, state and national public health entities found themselves adapting their recommendations for school closure. This article reviews Minnesota's experience with 2009 H1N1, focusing on the pandemic among school-aged children during the spring (April to August 2009) and fall (September 2009 to April 2010), and it chronicles how outbreak surveillance policies and recommendations for K-12 schools changed over the course of the pandemic.
