Vaccination Coverage by Age 24 Months Among Children Born in 2015 and 2016

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.
* Includes vaccinations received by age 24 months (before the day the child turns 24 months), except for the HepB birth dose, rotavirus vaccination, and ≥2 HepA doses by 35 months. For all vaccines, except the HepB birth dose and rotavirus vaccination, the Kaplan-Meier method was used to estimate vaccination coverage to account for children whose vaccination history was ascertained before age 24 months (35 months for ≥2 HepA doses).
^† Data for the 2013 birth year are from survey years 2014, 2015, and 2016; data for the 2014 birth year are from survey years 2015, 2016, and 2017; data for the 2015 birth year are from survey years 2016, 2017, and 2018; data for the 2016 birth year are considered preliminary and come from survey years 2017 and 2018 (data from survey year 2019 are not yet available).
^§ Includes children who might have received diphtheria and tetanus toxoids vaccine or diphtheria, tetanus toxoids, and pertussis vaccine.
^¶ Includes children who might have received measles, mumps, rubella, and varicella combination vaccine.
** Hib primary series: receipt of ≥2 or ≥3 doses, depending on product type received; full series: primary series and booster dose, which includes receipt of ≥3 or ≥4 doses, depending on product type received.
^†† One dose HepB administered from birth through age 3 days.
^§§ Statistically significantly different from 0 at p<0.05.
^¶¶ Includes ≥2 doses of Rotarix monovalent rotavirus vaccine, or ≥3 doses of RotaTeq pentavalent rotavirus vaccine. The maximum age for the final rotavirus dose is 8 months, 0 days.
*** Doses must be at least 24 days apart (4 weeks with a 4-day grace period).
^††† The combined 7-vaccine series (4:3:1:3*:3:1:4) includes ≥4 doses of DTaP, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, the full series of Hib (≥3 or ≥4 doses, depending on product type), ≥3 doses of HepB, ≥1 dose of varicella vaccine, and ≥4 doses of PCV.

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.
* Includes vaccinations received by age 24 months (before the day the child turns 24 months), except for the HepB birth dose, rotavirus vaccination, and ≥2 HepA doses by 35 months. For all vaccines, except the HepB birth dose and rotavirus vaccination, the Kaplan-Meier method was used to estimate vaccination coverage to account for children whose vaccination history was ascertained before age 24 months (35 months for ≥2 HepA doses).
^† Data for the 2015 birth year are from survey years 2016, 2017, and 2018; data for the 2016 birth year are considered preliminary and come from survey years 2017 and 2018 (data from survey year 2019 are not yet available).
^§ Children's health insurance status was reported by parent or guardian. "Other insurance" includes the Children's Health Insurance Program, military insurance, coverage via the Indian Health Service, and any other type of health insurance not mentioned elsewhere.
^¶ Includes children who might have received diphtheria and tetanus toxoids vaccine or diphtheria, tetanus toxoids, and pertussis vaccine.
** Statistically significant (p<0.05) difference compared with the referent group.
^†† Includes children who might have received measles, mumps, rubella, and varicella combination vaccine.^§§ Hib primary series: receipt of ≥2 or ≥3 doses, depending on product type received; full series: primary series and booster dose, which includes receipt of ≥3 or ≥4 doses, depending on product type received.
^¶¶ One dose HepB administered from birth through age 3 days.
*** Includes ≥2 doses of Rotarix monovalent rotavirus vaccine (RV1), or ≥3 doses of RotaTeq pentavalent rotavirus vaccine (RV5). The maximum age for the final rotavirus dose is 8 months, 0 days.
^††† Doses must be at least 24 days apart (4 weeks with a 4-day grace period).
^§§§ The combined 7-vaccine series (4:3:1:3*:3:1:4) includes ≥4 doses of DTaP, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, the full series of Hib (≥3 or ≥4 doses, depending on product type), ≥3 doses of HepB, ≥1 dose of varicella vaccine, and ≥4 doses of PCV.

Authors and Disclosures

Holly A. Hill, MD, PhD¹, James A. Singleton, PhD¹, David Yankey, PhD¹, Laurie D. Elam-Evans, PhD¹, S. Cassandra Pingali, MPH, MS¹ and Yoonjae Kang, MPH<sup>1

1</sup>Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Corresponding author
Holly A. Hill, hhill@cdc.gov, 404–639-8044.

Sidebar

Summary

What is already known about this topic?

The Advisory Committee on Immunization Practices recommends that children be vaccinated against 14 potentially serious illnesses before age 24 months.

What is added by this report?

Among children born in 2015 and 2016, coverage was high and stable for most vaccines. There were sociodemographic disparities in coverage, especially by health insurance status. The proportion of completely unvaccinated children remained small.

What are the implications for public health practice?

Coverage can be improved with increased access to providers and health insurance, administration of all recommended vaccines during office visits, and more effective patient education about vaccine safety and efficacy. Actionable local level data are a priority for creating targeted interventions to prevent outbreaks of measles and other vaccine-preventable diseases.

Figure.