CDC: Vaccination Coverage of Children Remains High

Rates of Unvaccinated, Vaccine-exempt Children Increase Slightly

October 19, 2018, 02:13 pm News Staff – A pair of CDC Morbidity and Mortality Weekly Reports (MMWRs) released Oct. 12 offered an overview of vaccination status among young children in the United States, most of which was positive.

Vaccination Status of Kindergarteners

The first MMWR focused on vaccine coverage and exemption rates among kindergarteners for the 2017-18 school year and found the median vaccination coverage was 95.1 percent for the state-required dosage series for diphtheria, tetanus and acellular pertussis (DTaP) vaccine.

The report, which summarized vaccine coverage and exemption estimates collected by state and local immunization programs for kindergarteners in 49 states and the District of Columbia, as well as data on kindergartners provisionally enrolled (attending school without complete vaccination or exemption while completing a catch-up vaccination schedule) or in a grace period (a set interval during which a student may be enrolled and attend school without proof of complete vaccination or exemption) for 28 states, also said vaccine coverage was 94.3 percent for the two doses of measles, mumps and rubella (MMR) vaccine. According to reports from 41 states and the District of Columbia, coverage was 93.8 percent for the two doses of varicella vaccine.

Vaccine coverage rates for all three of these immunizations increased compared to the previous year's data. That's the good news.

The bad news was that the median percentage of kindergartners with an exemption from at least one vaccine increased slightly -- for the third school year in a row -- to 2.2 percent, and the median percentage provisionally enrolled or attending school during a grace period was 1.8 percent.

"Vaccination coverage among kindergartners remained high; however, schools can improve coverage by following up with students who are provisionally enrolled, in a grace period or lacking complete documentation of required vaccinations," said the report.

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Vaccination Among Children Ages 19-35 Months

In the second MMWR, the CDC used National Immunization Survey data to assess vaccination coverage at national, state, territorial and selected local levels among children ages 19-35 months.

As with the kindergarteners, the CDC said overall vaccine coverage for this group remained "high and stable."

Specifically, coverage for the following vaccines was high:

three or more doses of poliovirus vaccine was 92.7 percent;
one or more dose of MMR was 91.5 percent;
three or more doses of hepatitis B (HepB) vaccine was 91.4 percent; and
one or more doses of varicella vaccine was 91 percent.

However, children were less likely to be up to date on these vaccines:

two or more doses of hepatitis A vaccine -- 59.7 percent;
the combined seven-vaccine series (i.e., four or more doses of DTaP, three or more doses of poliovirus vaccine, at least one dose of measles-containing vaccine, the full series of Haemophilus influenzae type b conjugate vaccine [Hib; three or more or four or more doses, depending on specific vaccine product], three or more doses of HepB vaccine, at least one dose of varicella vaccine, and four or more doses of pneumococcal conjugate vaccine [PCV]) -- 70.4 percent; and
rotavirus vaccine -- 73.2 percent.

Coverage for the HepB birth dose also was low, at just 73.6 percent, the agency said.

In addition, the CDC noted that among children in this age group, coverage for most vaccines was lower in uninsured children and those insured by Medicaid compared to those with private health insurance. The agency also noted that disparities were larger for vaccines that require a booster dose in the second year of life (e.g., DTaP, Hib and PCV).

The CDC said these disparities could be reduced with greater awareness and use of the Vaccines for Children program, eliminating missed opportunities to vaccinate, and minimizing interruptions in health insurance coverage.

The agency also noted that evidence-based strategies to improve vaccination coverage include notifying parents when children are due for a vaccination, establishing standing orders or policies that allow nonphysician personnel to administer vaccines, and enhancing computerized immunization information systems for tracking vaccinations.

And despite previous data from the National Immunization Survey that indicate the percentage of children who reach age 2 years without any vaccinations has increased gradually from 0.9 percent for children born in 2011 to 1.3 percent for children born in 2015, CDC officials remained confident that most children continue to be routinely vaccinated.

CDC, AAFP Release 2018 Immunization Schedules
Updates Include Preferential Shingrix Recommendation, Third MMR Dose for Some
(2/6/2018)