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

National Immunization Survey-Child, United States, 2016-2018

Holly A. Hill, MD, PhD; James A. Singleton, PhD; David Yankey, PhD; Laurie D. Elam-Evans, PhD; S. Cassandra Pingali, MPH, MS; Yoonjae Kang, MPH


Morbidity and Mortality Weekly Report. 2019;68(41):913-918. 

In This Article

Vaccination Coverage by Selected Characteristics and Geographic Location

For most of the vaccines assessed, uninsured children, and children with Medicaid or other nonprivate insurance, had lower coverage than did privately insured children (Table 2). Compared with privately insured children, coverage disparities were largest among uninsured children, ranging from 7.8 percentage points for the HepB birth dose to 33.8 percentage points for ≥2 doses of influenza vaccine. The proportion of children who received no vaccinations was higher among uninsured children (7.4%) than among those with private insurance (0.8%). Disparities were also observed for race/ethnicity (Supplementary Table 1,, poverty level (Supplementary Table 2,, and metropolitan statistical area§§ (MSA) (Supplementary Table 2, but tended to be smaller than those seen with health insurance status. Coverage varied widely by state/local area for many vaccines (Supplementary Table 3, Coverage with ≥1 dose of MMR was <90% in 20 states; only six states had coverage of 94% or higher (Figure).


Estimated coverage with ≥1 dose of MMR by age 24 months among children born 2015–2016* — National Immunization Survey-Child, United States, 2016–2018
Abbreviations: DC = District of Columbia; MMR = measles, mumps, and rubella vaccine.
* 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).

§§ MSA status was determined based on household reported city and county of residence and was grouped into three categories: MSA principal city, MSA nonprincipal city, and non-MSA. MSAs and principal cities were as defined by the U.S. Census Bureau ( Non-MSA areas include urban populations not located within an MSA as well as completely rural areas.