Vaccination Coverage Among Children Aged 19-35 Months - United States, 2017

Abstract

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination by age 24 months against 14 potentially serious illnesses (1). CDC used data from the 2017 National Immunization Survey-Child (NIS-Child) to assess vaccination coverage at national, state, territorial, and selected local levels among children aged 19-35 months in the United States. Coverage remained high and stable overall, exceeding 90% for ≥3 doses of poliovirus vaccine, ≥1 dose of measles, mumps, and rubella vaccine (MMR), ≥3 doses of hepatitis B vaccine (HepB), and ≥1 dose of varicella vaccine. Although the proportion of children who received no vaccine doses by age 24 months was low, this proportion increased gradually from 0.9% for children born in 2011 to 1.3% for children born in 2015. Coverage was lower for most vaccines among uninsured children and those insured by Medicaid, compared with those having private health insurance, and for children living outside of metropolitan statistical areas* (MSAs), compared with those living in MSA principal cities. These disparities could be reduced with greater awareness and use of the Vaccines for Children^† (VFC) program, eliminating missed opportunities to vaccinate children during visits to health care providers, and minimizing interruptions in health insurance coverage.

FIGURE

Estimated linear trend in coverage with selected vaccines by age 24 months, by month and year of birth — National Immunization Survey-Child, United States, 2013–2017 Abbreviations: CI = confidence interval; DTaP = diphtheria, tetanus toxoids, and acellular pertussis vaccine; HepA = hepatitis A vaccine; HepB = hepatitis B vaccine; Hib = Haemophilus influenzae type b conjugate vaccine; MMR = measles, mumps, and rubella vaccine; PCV = pneumococcal conjugate vaccine. * Hib full series: ≥3 or ≥4 doses, depending on product type received (primary series and booster dose). Rotavirus: ≥2 or ≥3 doses, depending on product type received (≥2 doses for Rotarix [RV1] or ≥3 doses for RotaTeq [RV5]). ^† Except for rotavirus, vaccination coverage was assessed before the child reached his/her 24-month birthday. The Kaplan-Meier method was used to account for censoring vaccination status for children assessed before age 24 months. Rotavirus vaccination was assessed before the child reached his/her 8-month birthday. ^§ Estimated linear relationship between month and year of birth and vaccination coverage, based on weighted linear regression analysis using the inverse of the estimated variance of each point estimate to construct the weights. Estimated percentage point change over 12 birth months: ≥4 DTaP −0.55 (95% CI = -1.20 to 0.10); ≥3 poliovirus -0.17 (-0.52 to 0.18); ≥1 MMR -0.11 (-0.58 to 0.35); Hib full series -0.51 (-1.13 to 0.11); ≥3 HepB -0.53 (-0.97 to -0.09); ≥1 varicella -0.05 (-0.53 to 0.42); ≥4 PCV 0.0 (-0.69 to 0.68); ≥2 HepA 1.13 (0.30 to 1.97); rotavirus 0.68 (-0.09 to 1.45).