Notice to Readers: National Vaccination Coverage Levels Among Children Aged 19-35 Months -- United States, 1998
Sustained high vaccination coverage levels in the United States are necessary to decrease rates of vaccine-preventable diseases. Therefore, an important component of the U.S. vaccination program is the assessment of vaccination coverage (1). To assist in this assessment, in 1993, the Childhood Immunization Initiative (CII) was begun to increase vaccination coverage levels among children during the first 2 years of life to greater than or equal to 90% by 1996 for universally recommended childhood vaccinations and to monitor trends in vaccination coverage. Vaccination objectives also were included in the national health objectives for 2000 initiative (2). Except for hepatitis B vaccine, the 90% coverage goals were achieved and maintained through implementation of CII by public- and private-sector organizations and health-care providers at the national, state, and local levels (3).
CDC's National Immunization Survey (NIS) provides ongoing estimates of vaccination coverage in the United States (3,4). In 1998, the NIS assessed vaccination coverage levels among children born during February 1995-May 1997 (i.e., aged 19-35 months; median age: 27 months).
National vaccination coverage achieved was greater than or equal to 90% each for three doses of poliovirus vaccine, three doses of Haemophilus influenzae type b vaccine, and one dose of measles-containing vaccine. Coverage with four doses of diphtheria and tetanus toxoids and pertussis vaccine/diphtheria and tetanus toxoids (DTP/DT) and three doses of hepatitis B vaccine was the highest ever reported (84% and 87%, respectively). Varicella vaccine, first recommended for use in 1996, also had the highest coverage ever reported (43.2%) (Table 1). State-specific coverage estimates for each recommended antigen and for two combined series of vaccines and coverage estimates by state among children living in poverty will be published in CDC Surveillance Summaries.
References
Orenstein W, Hinman A, Rodewald L. Public health considerations--United States. In: Plotkin SA, Orenstein WA, eds. Vaccines. 3rd ed. Philadelphia, Pennsylvania: WB Saunders, 1999:1006-32.
Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.
CDC. National, state, and urban area vaccination coverage levels among children aged 19-35 months--United States, 1997. MMWR 1998;47:547-54.
CDC. Sample design in procedures to produce estimates of vaccination coverage in the national immunization survey. Atlanta, Georgia: US Department of Health and Human Services, CDC, National Immunization Program, April 18, 1996.
Note:
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TABLE 1. Vaccination coverage levels among children aged 19-35 months, by selected vaccines -- United States, National Immunization Survey, 1995-1998*
1995
1996
1997
1998
Vaccine/Dose
%
(95% CI)
%
(95% CI)
%
(95% CI)
%
(95% CI)
DTP/DT§
>=3 Doses
94.7
(±0.6)
95.0
(±0.4)
95.5
(±0.4)
95.6
(±0.5)
>=4 Doses
78.5
(±1.0)
81.1
(±0.7)
81.5
(±0.7)
83.9
(±0.8)
Poliovirus
>=3 Doses
87.9
(±0.8)
91.1
(±0.5)
90.8
(±0.5)
90.8
(±0.7)
Haemophilus influenzae type b (Hib)
>=3 Doses
91.7
(±0.6)
91.7
(±0.5)
92.7
(±0.5)
93.4
(±0.6)
Measles-containing vaccine (MCV)
>=1 Doses
89.9
(±0.7)
90.7
(±0.5)
90.5
(±0.5)
92.1
(±0.6)
Hepatitis B
>=3 Doses
68.0
(±1.0)
81.8
(±0.7)
83.7
(±0.6)
87.0
(±0.7)
Varicella vaccine
1 Dose
NA¶
16.0
(±0.7)
25.9
(±0.7)
43.2
(±1.0)
Combined series
4 DTP/3 Polio/1 MCV**
76.2
(±1.0)
78.4
(±0.8)
77.9
(±0.7)
80.6
(±0.9)
4 DTP/3 Polio/1 MCV/3 Hib
74.2
(±1.0)
76.5
(±0.8)
76.2
(±0.8)
79.2
(±0.9)
* Children were born during February 1992-May 1994 (1995 survey), February 1993-May 1995 (1996 survey), February 1994-May 1996 (1997 survey), and February 1995-May 1997 (1998 survey). Confidence interval. § Diphtheria and tetanus toxoids and pertussis vaccine/diphtheria and tetanus toxoids. ¶ Not available. Data collection for varicella began in July 1996. ** Four or more doses of DTP/DT, three or more doses of poliovirus vaccine, and one or more doses of MCV. Four of more doses of DTP/DT, three or more doses of poliovirus vaccine, one or more doses of MCV, and three or more doses of Hib.
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