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Vaccination Coverage

Narrative

Vaccination is one of the greatest public health achievements of the 20th century, resulting in dramatic declines in morbidity and mortality for many infectious diseases.1 Childhood vaccination in particular is considered among the most cost-effective preventive services available, as it averts a potential lifetime lost to death and disability.2

Currently, there are 12 different vaccines recommended by the Centers for Disease Control and Prevention from birth through age 18, many of which require multiple doses for effectiveness as well as boosters to sustain immunity (CDC vaccination schedules).

In 2010, 72.7 percent of children 19–35 months of age received each of six vaccines in a modified series of recommended vaccines (4:3:1:3:X:1:4). This series includes four doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP/DT/DTP); three doses of poliovirus vaccine; one dose of measles, mumps, and rubella vaccine (MMR); three doses of the hepatitis B vaccine (HepB); one dose of the varicella (chicken pox) vaccine; and four doses of the pneumococcal conjugate vaccine (PCV). Because of changes in measurement of the Haemophilus influenzae type b (Hib) vaccine and the vaccine shortage that occurred during December 2007– June 2009, coverage estimates included here are based on the modified series that excludes the Hib vaccine. Although the 2010 level of vaccine series coverage is below the Healthy People 2020 objective of 80 percent, there were no significant disparities by race and ethnicity.

The human papillomavirus (HPV) vaccine protects against certain strains of HPV that can cause cervical cancer and genital warts and was first recommended in 2006 for females aged 11–12 years and more recently recommended for males of the same age, with catch-up vaccination at later ages for females (13–26 years) and males (13–21 years) who have not completed the 3-dose series.3 In 2010, only 48.7 percent of females aged 13–17 years had received at least 1 of the 3 necessary doses of HPV vaccine, among whom about two-thirds with adequate time to complete the series had done so (69.6 percent). Hispanic and non-Hispanic American Indian/ Alaska Native females were significantly more likely to have initiated HPV vaccination than non-Hispanic White females (56.2 and 64.8 percent versus 45.8 percent, respectively). However, compared to non-Hispanic White females, Hispanic and non-Hispanic Black females were less likely to complete the vaccine series (74.7 percent versus 56.1 and 65.4 percent, respectively), while non-Hispanic Asian females were more likely to do so (86.0 percent). A new requirement of health plans to monitor the proportion of females completing 3 doses by 13 years of age may help to increase HPV vaccination.4

Each year, the Centers for Disease Control and Prevention publishes an update of the childhood immunization schedule.

1 Centers for Disease Control and Prevention (CDC). Achievements in public health, 1900–1999: Control of infectious diseases. MMWR. 1999 Jul 30;48(29):621-9

2 Maciosek MV, Coffield AB, Edwards NM, Flottemesch TJ, Goodman MJ, Solberg LI. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prev Med. 2006 Jul;31(1):52-61

3 Centers for Disease Control and Prevention. HPV Vaccination. Accessed: July 5, 2012.

4 National Committee for Quality Assurance. Healthcare Effectiveness Data and Information Set (HEDIS) 2012 technical specifications for health plans. Volume 2. Washington, DC: National Committee for Assurance; 2011. Accessed: July 5, 2012.

Graphs

This image is described in the Data section.

vaccination rates graph

Data

Receipt of Selected Vaccinations Among Children, by Recommended Age Group and Race/Ethnicity,* 2010
Race/Ethnicity Percent of Children
19-35 Months, 4:3:1:x:3:1:4
Modified Series**
13-17 Years, HPV initiation† 13-17 Years, HPV Completion‡
*The sample of Native Hawaiian/Pacific Islanders was too small to produce reliable results.
**+ DTaP, 3+ Polio, 1+ MMR, 3+ HepB, 1+ Varicella, 4+ PCV; excludes Hib, due to the 2007-2009 shortage.
†1+ HPV among females only.
‡3+ doses among females who had at least one HPV dose and at least 24 weeks between the first dose and time of the survey.
Source: Centers for Disease Control and Prevention. U.S. Vaccination Coverage Reported by the National Immunization Survey. Accessed on 07/05/12.
Total 72.7 48.7 69.6
Non-Hispanic White 72.7 45.8 74.7
Non-Hispanic Black 69.3 48.9 65.4
Hispanic 74.1 56.2 56.1
Non-Hispanic American Indian/Alaska Native 74.5 64.8 64.0
Non-Hispanic Asian 70.2 50.1 86.0