Background: Childhood immunization rates are at an all-time high globally, and national data for China suggests close to universal coverage. Refugees from North Korea and their children may have more limited health care access in China due to their legal status. However, there is no data on immunization rates or barriers to coverage in this population. Methods: This study was conducted to determine the rates and correlates of immunizations in children (≥1 year) born to North Korean refugees in Yanbien, China. Child immunization data was obtained from vaccination cards and caregiver self-report for 7 vaccines and 1:3:3:3:1 series. Age-appropriate vaccination rates of refugee children were compared to Chinese and migrant children using a goodness-of-fit test. Logistic regression was used to determine correlates of immunization coverage for each vaccine and the 1:3:3:3:1 series. Results: Age-appropriate immunization coverage rates were significantly lower in children born to North Korean refugees (12.1-97.8 %), compared to Chinese (99 %) and migrant (95 %) children. Increased father's age and having a sibling predicted significantly lower vaccination rates. Conclusions: Children born to North Korean refugees had significantly lower immunization rates, compared to Chinese or migrant children. Further research is needed to examine barriers of health care access in this high-risk population. © 2016 Chung et al.

Child health health disparities Immunization North Korean refugees in China

China sibling educational status Chinese refugee North Korean childhood immunization Democratic People's Republic of Korea insurance human Refugees Self Report statistics and numerical data controlled study Reproductive History ethnology human rights Surveys and Questionnaires income cross-sectional study migrant Humans male female preschool child Infant preventive health service Child, Preschool measles vaccination BCG vaccination North Korea questionnaire paternal age child health standards Article adult migration health care access global health correlational study Immunization Programs Transients and Migrants vaccination retrospective study immunization Universal Coverage Healthcare Disparities health care disparity Health Services Accessibility health care delivery Child