Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Teresa Waters

Committee Member

Dr. Kathi Harp

Committee Member

Dr. Frank Romanelli


The purpose of this project is to examine the relationship between county-level socioeconomic factors and immunization compliance rates among kindergarten age children. All 120 counties in Kentucky were included in this evaluation.

County-level percent of uninsured children, number of children in poverty, children receiving free lunch (percentage), unemployment rate (percentage), and high school graduation rate were assessed. Socioeconomic data for each county were compared to county-level kindergarten vaccination rates. All vaccination data were obtained from the 2015-2016 Kentucky Annual School Immunization Survey Report. All socioeconomic county data were obtained from the 2016 County Health Rankings data, published by the Robert Wood Johnson Foundation.

County-level socioeconomic variables did not significantly differ between counties that met and did not meet all Healthy People 2020 vaccination goals. Higher rates of uninsured children were significantly related to higher compliance rates of total vaccination, MMR, Polio, and varicella. Higher rates of education (high school graduation rate and percent of adults with some college) were significantly related to higher DTaP and Polio vaccination rates.

This analysis provides guidance for target populations where best practices for improving vaccine compliance can be implemented.

Included in

Public Health Commons