Differences in uptake of immunisations and health examinations among refugee children compared to Danish-born children: a cohort study

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. What is Known: • Uptake of immunisation and child health examination is associated with low household income, unemployment and low educational status among the parents. • Uptake may be even lower among refugee families as they constitute a vulnerable group regarding access to healthcare. What is New: • Refugee children had lower uptake of immunisations and child health examinations compared to Danish-born children. • Several predictors of uptake were identified including region of origin and duration of residence.