Trends in the Well-Being of America's Children and Youth, 2000. HC 3.3 Immunization: Percentage of Children ages 19 Months to 35 Months Who Are Fully Immunized

01/01/2000

Childhood vaccinations can prevent diseases that killed or permanently impaired many children in past decades. The Centers for Disease Control and Prevention recommends that 80 percent of all routine childhood vaccinations be administered within the first 2 years of life. Vaccination coverage is particularly important before children enter preschool to prevent the spread of disease. Today, at least 95 percent of children are adequately vaccinated by the time they enter kindergarten.56

There were substantial increases in the proportion of children vaccinated between 1991 and 1994 for each of the recommended vaccines (data not shown).57 Coverage has continued to increase during the period from 1994 to 1998. For example, the percentage of preschool children receiving the combined series 4:3:1:3 vaccine was 69 percent in 1994 and reached 79 percent by 1998 (see Table HC 3.3).58 Even with the increases of recent years, more than 1 million preschool children remain unvaccinated for serious preventable diseases.59 In particular, there are differences in immunization rates by poverty status and race and Hispanic origin.

Differences by Race and Hispanic Origin.60 Non-Hispanic white infants ages 19 months to 35 months have higher percentages of vaccination receipt than do non-Hispanic black children or children of Hispanic origin (see Table HC 3.3). This disparity in vaccination levels has narrowed somewhat from 1994 to 1997, as the vaccination levels of black and Hispanic children have improved. By preschool, the vaccination levels of children across racial and ethnic groups are nearly the same, narrowing a gap that once was as wide as 26 percentage points for specific vaccinations.61 Differences in vaccination rates among racial and ethnic groups are partly accounted for by poverty level.62

Differences by Poverty Status. Although vaccination levels have increased substantially between 1995 and 1998 among children in households at or above the poverty level, poor children are still less likely to have received recommended vaccinations.63 In 1998, 82 percent of children in families at or above the poverty level received the combined series 4:3:1:3, compared with 74 percent of poor children (see Table HC 3.3).

Figure HC 3.3 Percentage of childrena ages 19 months to 35 months in the United States who have received vaccinations for routinely recommended vaccines:b 1997

Figure HC 3.3 Percentage of childrena ages 19 months to 35 months in the United States who have received vaccinations for routinely recommended vaccines:b 1997

a Data are based on telephone interviews of a sample of the civilian, noninstitutionalized population, with households selected via a random digit dial (RDD) procedure. Refusals and unknowns were excluded. Exclusions included unknown vaccine type.

b The combined series 4:3:1:3 consists of four doses of diphtheria-tetanus-pertussis (DTP) vaccine, three doses of polio vaccine, one dose of a measles-containing vaccine, and three doses of Haemophilus influenzae type b (HiB) vaccine. The combined series 4:3:1 consists of four doses of DTP vaccine, three doses of polio vaccine, and one dose of a measles-containing vaccine.

Source: Centers for Disease Control and Prevention. National Center for Health Statistics and National Immunization Program, 2000, Table 73.


Table HC 3.3 Percentage of children ages 19 months to 35 months in the United States who have received routinely recommended vaccinations, by poverty statusa and race and Hispanic origin:b1994c -1998

  All races White, non-Hispanic Black, non-Hispanic Hispanic
Vaccination type Total Below poverty At or above poverty Total Below poverty At or above poverty Total Below poverty At or above poverty Total Below poverty At or above poverty
Combined series (4:3:1:3)d
1994 69 61 72 72 67 62
1995 74 67 77 77 68 79 70 66 75 69 65 72
1996 77 69 80 79 68 81 74 70 78 71 68 74
1997 76 71 79 79 72 80 73 71 77 72 70 76
1998 79 74 82 82 77 83 73 72 74 75 73 79
Combined series (4:3:1)e
1994 75 66 78 78 69 68
1995 76 68 79 79 72 71
1996 78 71 81 80 70 82 76 73 80 73 70 75
1997 78 73 80 80 73 82 74 72 78 74 72 77
1998
DTP (3 doses or more)f
1994 93 89 96 95 91 90
1995 95 91 96 96 92 93
1996 95 92 96 96 92 97 93 91 95 93 92 94
1997 95 93 97 97 93 97 95 95 96 93 92 94
1998
DTP (4 doses or more)f
1994 76 69 79 80 72 70
1995 79 71 81 81 74 75
1996 81 73 84 83 72 85 79 75 82 77 73 79
1997 81 76 84 84 76 85 78 76 80 77 75 80
1998 84 80 86 87 77 81
Polio (3 doses or more)                        
1994 83 78 85 85 79 81
1995 88 84 89 89 84 87
1996 91 88 92 92 88 93 90 88 92 89 88 90
1997 91 90 92 92 90 92 90 90 91 90 89 90
1998 91 90 92 92 88 89
Measles-containingg
1994 89 87 90 90 86 88
1995 90 85 91 91 86 88
1996 91 87 92 92 86 93 89 88 91 88 88 89
1997 91 86 92 92 85 93 90 88 92 88 86 89
1998 92 90 93 93 89 91

Table HC 3.3 continued. Percentage of children ages 19 months to 35 months in the United States who have received routinely recommended vaccinations, by poverty statusa and race and Hispanic origin:b1994c -1998

  All races White, non-Hispanic Black, non-Hispanic Hispanic
Vaccination type Total Below poverty At or above poverty Total Below poverty At or above poverty Total Below poverty At or above poverty Total Below poverty At or above poverty
HiB (3 doses or more)h
1994 86 81 88 87 85 84
1995 92 88 93 93 89 90
1996 92 88 93 93 87 94 90 87 92 89 88 90
1997 93 90 94 94 90 95 92 92 94 90 89 92
1998 93 91 95 95 90 92  
Hepatitis B (3 doses or more)i
1994 37 25 41 40 29 33
1995 68 64 69 68 65 69
1996 82 78 83 82 75 83 82 79 86 80 79 82
1997 84 80 85 85 80 85 83 82 84 81 79 84
1998 87 85 88 88 84 86

a Poverty status is based on family income and family size using U.S. Bureau of the Census poverty thresholds.

b Estimates for whites and blacks exclude Hispanics of those races. Persons of Hispanic origin may be of any race.

c Estimates are based on interviews conducted from April 1994 through December 1994.

d The combined series 4:3:1:3 consists of four doses of diphtheria-tetanus-pertussis (DTP) vaccine, three doses of polio vaccine, one dose of a measles-containing vaccine, and three doses of Haemophilus influenzae type b (HiB) vaccine.

e The combined series 4:3:1 consists of four doses of DTP vaccine, three doses of polio vaccine, and one dose of a measles-containing vaccine.

f Diphtheria-tetanus-pertussis vaccine.

g Any vaccination containing measles vaccine.

h Haemophilus influenzae type b vaccine.

i The percentage of children 19-35 months of age who received three or more doses of hepatitis B vaccine was artificially low in 1994 because universal infant vaccination with a three-dose series was not recommended until November 1991.

Sources: Unpublished data from the National Immunization Survey, National Center for Health Statistics and National Immunization Program, Centers for Disease Control and Prevention; Centers for Disease Control and Prevention. 1998; Table 1; Centers for Disease Control and Prevention, 1998, Table 1 and text; National Center for Health Statistics, 1997, Table 55; Centers for Disease Control and Prevention, 1997, Tables 1 and 2; National Center for Health Statistics, 1998. Table 52.

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