Abstract
Sustained high coverage with recommended vaccinations among children has kept many vaccine-preventable diseases at low levels in the United States (1). To assess coverage with vaccinations recommended for children by age 2 years in the United States (2), CDC analyzed data collected by the 2015 National Immunization Survey (NIS) for children aged 19-35 months (born January 2012-May 2014). Overall, coverage did not change during 2014-2015. Coverage in 2015 was highest for ≥3 doses of poliovirus vaccine (93.7%), ≥3 doses of hepatitis B vaccine (HepB) (92.6%), ≥1 dose of measles, mumps, and rubella vaccine (MMR) (91.9%), and ≥1 dose of varicella vaccine (91.8%). The data were also examined for potential vaccination coverage differences by race/ethnicity, poverty status, and urbanicity. Although disparities were noted for each of these factors, the most striking differences were seen for poverty status. Children living below the federal poverty level* had lower coverage with most of the vaccinations assessed compared with children living at or above the poverty level; the largest disparities were for rotavirus vaccine (66.8% versus 76.8%), ≥4 doses of pneumococcal conjugate vaccine (PCV) (78.9% versus 87.2%), the full series of Haemophilus influenzae type b vaccine (Hib) (78.1% versus 85.5%), and ≥4 doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP) (80.2% versus 87.1%). Although coverage was high in some groups, opportunities exist to continue to address disparities. Implementation of evidence-based interventions, including strategies to enhance access to vaccination services and systems strategies that can reduce missed opportunities, has the potential to increase vaccination coverage for children living below the poverty level and in rural areas (3).
Highlights
Vaccination has resulted in substantial reductions in morbidity and mortality from childhood diseases in the United States
As new vaccines, such as varicella, pneumococcal conjugate, and rotavirus have been recommended by the Advisory Committee on Immunization Practices, the National Immunization Survey (NIS) has been able to provide important information on vaccine coverage among U.S. children aged [19–35] months and on progress toward meeting coverage targets
Systems-based interventions, such as patient reminder and recall systems, provider reminders, establishment of standing orders for vaccination, and further development of immunization information systems might be useful in improving vaccination coverage among all young children in the United States
Summary
To assess coverage with vaccinations recommended for children by age 2 years in the United States (2), CDC analyzed data collected by the 2015 National Immunization Survey (NIS) for children aged [19–35] months (born January 2012–May 2014). The data were examined for potential vaccination coverage differences by race/ethnicity, poverty status, and urbanicity. Details regarding NIS methodology and weighting have been described previously.§ For 2015, national vaccination coverage estimates were based on a sample of 15,167 children with completed household interviews and adequate provider data. The Council of American Survey Research Organizations (CASRO) response rate was 34.9%.¶ Logistic regression was used to assess differences among racial/ethnic groups, controlling for poverty status, and to evaluate the potential interaction between poverty status and Metropolitan Statistical Area** (MSA) status (a measure of urbanicity).
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