TY - JOUR

T1 - Differences in uptake of immunisations and health examinations among refugee children compared to Danish-born children

T2 - a cohort study

AU - Moller, Sanne Pagh

AU - Hjern, Anders

AU - Andersen, Anne-Marie Nybo

AU - Norredam, Marie

PY - 2016/4

Y1 - 2016/4

N2 - Refugee children and their families constitute a vulnerable group regarding health and access to care. In a register-based cohort design, we examined differences in uptake of immunisations and child health examinations between refugee children and Danish-born children, including predictors of uptake among refugee children. Refugee children (n = 16,701) who, between January 1993 and December 2010, obtained residency permits in Denmark were included and matched in a 1:6 ratio on age and sex with Danish-born children (n = 100,206). Personal identification numbers were cross-linked to the National Danish Health Service Register, identifying all contacts for immunisation and child health examinations. We estimated hazard ratios (HR) of uptake. Refugee children had a lower uptake of all immunisations compared to Danish-born children. The lowest uptake was found for immunisation against diphtheria, tetanus, pertussis and polio (HR = 0.50; 95 % confidence interval (CI) 0.48–0.51). Participation in child health examinations was also lower among refugee children with the lowest at the last child health examination at age 5 (HR = 0.48; 95 % CI 0.47–0.50). Adjusting the analysis for parental income increased the HRs by 10–20 %.Conclusion: This Danish register-based study using nationwide data revealed a lower uptake of routine immunisations and child health examinations among refugee children compared to Danish-born children.

AB - Refugee children and their families constitute a vulnerable group regarding health and access to care. In a register-based cohort design, we examined differences in uptake of immunisations and child health examinations between refugee children and Danish-born children, including predictors of uptake among refugee children. Refugee children (n = 16,701) who, between January 1993 and December 2010, obtained residency permits in Denmark were included and matched in a 1:6 ratio on age and sex with Danish-born children (n = 100,206). Personal identification numbers were cross-linked to the National Danish Health Service Register, identifying all contacts for immunisation and child health examinations. We estimated hazard ratios (HR) of uptake. Refugee children had a lower uptake of all immunisations compared to Danish-born children. The lowest uptake was found for immunisation against diphtheria, tetanus, pertussis and polio (HR = 0.50; 95 % confidence interval (CI) 0.48–0.51). Participation in child health examinations was also lower among refugee children with the lowest at the last child health examination at age 5 (HR = 0.48; 95 % CI 0.47–0.50). Adjusting the analysis for parental income increased the HRs by 10–20 %.Conclusion: This Danish register-based study using nationwide data revealed a lower uptake of routine immunisations and child health examinations among refugee children compared to Danish-born children.

KW - Access

KW - Child healthcare

KW - Immunisations

KW - Refugee

KW - Children

KW - Register-based

KW - Migration

U2 - 10.1007/s00431-015-2663-9

DO - 10.1007/s00431-015-2663-9

M3 - Journal article

C2 - 26567542

VL - 175

SP - 539

EP - 549

JO - Acta Paediatrica Hungarica

JF - Acta Paediatrica Hungarica

SN - 0340-6199

IS - 4

ER -