Doctors' Views

Vaccination Coverage of Children -- At All-Time High

On September 23, 1999, the Secretary of the Health and Human Services, Donna Shalala, announced that the overall immunization rates in the United States for children aged 19 to 35 months reached an all-time high in 1998. Her statement was based on findings that appeared in the Morbidity and Mortality Weekly Report (MMWR) issued by the Centers for Disease Control and Prevention (CDC).

Sustained high vaccination coverage levels are necessary to decrease the rates of vaccine-preventable diseases. Therefore, a key component of a vaccination program is the assessment of vaccination coverage. In this regard, the Childhood Immunization Initiative was begun in the U.S. in 1993. The aims were:

• To increase vaccination coverage levels among children during the first 2 years of life to 90% or above by 1996 for all universally recommended childhood vaccinations; and
• To monitor the trends in vaccination coverage.

In 1998, the CDC assessed the vaccination coverage levels among children who had been born between February 1995 and May 1997 and who were 19-35 months old(median age: 27 months) at the time of the study.

National vaccination coverage was found to be equal to or greater than 90% for the poliovirus vaccine, the Haemophilus influenzae (H. flu) type b vaccine, and the measles vaccine. The polio vaccination rate remained the same between 1997 and 1998 at 90.8%. The vaccination rate for H. flu increased to 93.4% in 1998. The rate of measles vaccination rose to 92.1%.

Vaccination coverage for the diphtheria/tetanus /pertussis (DTP) and diphtheria/tetanus (DT) and for the hepatitis B vaccine was the highest ever reported. The hepatitis B vaccination rate, however, was under the 90% target and only reached 87.0%.

Varicella (chickenpox) vaccination, which was first recommended for use in 1996, had the highest coverage ever reported. Immunization for chickenpox increased from 25.9% in 1997 to 43.2% in 1998. This was the greatest rise for any type of vaccination.

The 90% coverage goal -- to increase vaccination coverage levels to 90% or above among children during the first 2 years of life -- was thus achieved and maintained, except for the hepatitis B vaccine.

Source: National vaccination coverage levels among children aged 19-35 months - United States, 1998. MMWR 48: 829-830, (Sept. 24) 1999.