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IID-8 Data Details

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IID-8 Increase the percentage of children aged 19 to 35 months who receive the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella and pneumococcal conjugate vaccine (PCV)
LHI

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data: National

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
68.4 (2012)
Target: 
80.0
Target-Setting Method: 
Maintain consistency with national programs, regulations, policies, and laws.
Target-Setting Method Justification: 
Although measuring coverage estimates for individual vaccines is necessary, capturing a measure of “completeness” of ACIP-recommended vaccines for young children also is important. High coverage targets have allowed for dramatic control of vaccine-preventable diseases in the United States. A completeness measure has a target of 80 percent because not all of the vaccines included in this series have reached 90 percent coverage. Achieving this target will be more difficult than for the individual vaccines.
Numerator: 

Number of children aged 19 to 35 months receiving at least four doses of diphtheria-tetanus-acellular pertussis (DTaP), at least three doses of polio, at least one dose of measles-containing vaccine, at least three or four doses of Haemophilus influenzae B (Hib) depending on the brand used, at least three doses of hepatitis B antigens, at least one dose of varicella, and at least four doses of PCV

Denominator: 

Number of children aged 19 to 35 months

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From the 2013 National Immunization Survey Provider-Immunization History Questionnaire:

    [NUMERATOR:]

    Specify month, day, and year that each vaccine was given, either by the office or another provider, and type of vaccine, as documented in the records.

Data Collection Frequency: 
Annual
Leading Health Indicator:
Immunization and Infectious Diseases
Methodology Notes: 

    The National Immunization Survey (NIS) uses a quarterly, random-digit-dialed sample of telephone numbers to reach households with children aged 19–35 months in the 50 states and selected local areas and territories, followed by a mail survey sent to the children's vaccination providers to collect vaccination information. Data are weighted to represent the population of children aged 19–35 months, with adjustments for households with multiple telephone lines and mixed telephone use (landline and cellular), household nonresponse, and exclusion of households without telephone service. Beginning in 2011, surveys include landline and cellular telephone households.

    This measure tracks the proportion of children aged 19 to 35 months receiving the routine series of recommended vaccinations, refered to as 4:3:1:3:3:1:4 series. This series includes at least four doses of diphtheria-tetanus-acellular pertussis (DTaP), at least three doses of polio, at least one dose of measles-containing vaccine, at least three or four doses of Haemophilus influenzae B (Hib) vaccine depending on the brand used, at least three doses of hepatitis B, at least one dose of varicella antigens, and at least 4 doses of pneumococcal conjugate vaccine (PCV). The number of Hib vaccine doses required differs according to manufacturer (brand). This measure does take into account the brand of vaccine used and assumes that doses with missing Hib type/brand information are a type requiring 4 doses to be up-to-date.

Trend Issues: 
The Hib shortage from Dec 2007 to Sept 2009 and the resulting ACIP recommendation to suspend the booster dose of Hib.
Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 14-24a in that the list of vaccines included was revised from DTaP, polio, MMR, Hib, and hepatitis B to DTaP, polio, MMR, Hib, hepatitis B, varicella, and PCV. In addition, the Hib definition was revised from children receiving "at least 3 doses of Hib" to "at least 3 or 4 doses of Hib, depending on the vaccine brand."

About the Data: State

Description of the data source, numerator, denominator, survey questions, and other relevant details about the state-level data.

Data Source: 
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Measure: 
percent
Numerator: 

Number of children aged 19 to 35 months receiving at least four doses of diphtheria-tetanus-acellular pertussis (DTaP), at least three doses of polio, at least one dose of measles-containing vaccine, at least three or four doses of Haemophilus influenzae B (Hib) depending on the brand used, at least three doses of hepatitis B antigens, at least one dose of varicella, and at least four doses of PCV

Denominator: 

Number of children aged 19 to 35 months

Questions Used to Obtain the State Data: 

      From the 2013 National Immunization Survey Provider-Immunization History Questionnaire:

      [NUMERATOR:]

      Specify month, day, and year that each vaccine was given, either by the office or another provider, and type of vaccine, as documented in the records.

Data Collection Frequency: 
Annual
Methodology Notes: 

      The National Immunization Survey (NIS) uses a quarterly, random-digit-dialed sample of telephone numbers to reach households with children aged 19–35 months in the 50 states and selected local areas and territories, followed by a mail survey sent to the children's vaccination providers to collect vaccination information. Data are weighted to represent the population of children aged 19–35 months, with adjustments for households with multiple telephone lines and mixed telephone use (landline and cellular), household nonresponse, and exclusion of households without telephone service. Beginning in 2011, surveys include landline and cellular telephone households.

      This measure tracks the proportion of children aged 19 to 35 months receiving the routine series of recommended vaccinations, refered to as 4:3:1:3:3:1:4 series. This series includes at least four doses of diphtheria-tetanus-acellular pertussis (DTaP), at least three doses of polio, at least one dose of measles-containing vaccine, at least three or four doses of Haemophilus influenzae B (Hib) vaccine depending on the brand used, at least three doses of hepatitis B, at least one dose of varicella antigens, and at least 4 doses of pneumococcal conjugate vaccine (PCV). The number of Hib vaccine doses required differs according to manufacturer (brand). This measure does take into account the brand of vaccine used and assumes that doses with missing Hib type/brand information are a type requiring 4 doses to be up-to-date.

Trend Issues: 
The Hib shortage from Dec 2007 to Sept 2009 and the resulting ACIP recommendation to suspend the booster dose of Hib.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2012, the original baseline was revised from 68 (2008) to 44.3 (2009). This change was made because the 2009 National Immunization Survey (NIS) introduced a new method for measuring Hib vaccination coverage to distinguish between Hib vaccine product types that require a different number of doses for full vaccination. These 2009 NIS data were not available during the target-setting process in early 2010. The target was not revised. In 2015, the baseline year was revised from 2009 to 2012 due to expanding the sampling frame from landline phones only to a dual frame sample including landline and cell phones. The baseline statement was changed from "44.3 percent of children aged 19 to 35 months in 2009 received the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella, and PCV " to "68.4 percent of children aged 19 to 35 months in 2012 received the recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella, and PCV." The target remains unchanged. In 2014, 2009 through 2011 data were revised to correct errors in programming, in particular the estimates by sex and country of birth. The baseline estimate for the total population and target remained the same.

References

Additional resources about the objective

  1. CDC. National and State Vaccination Coverage Among Children Aged 19--35 Months --- United States, 2010. MMWR 2011:60(34):1157-1163.
  2. CDC. National, State, and Local Area Vaccination Coverage Among Children Aged 19--35 Months --- United States, 2009. MMWR 2010;59(36):1171-1177.
  3. CDC. National, State, and Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2011. MMWR 2012;61(35):689-696.