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Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: [email protected]. Type 508 Accommodation and the title of the report in the subject line of e-mail. Status Report on the Childhood Immunization Initiative: National, State, and Urban Area Vaccination Coverage Levels Among Children Aged 19-35 Months -- United States, 1996The Childhood Immunization Initiative (CII), a comprehensive response to undervaccination among preschool-aged children, was initiated in the United States in 1993 (1). The CII established the goal of increasing vaccination coverage levels among children aged 2 years to greater than or equal to 90% by 1996 for the most critical doses of each vaccine routinely recommended for children * (except hepatitis B vaccine, for which the objectives were to increase coverage to 70% by 1996 and 90% by 1998). ** This report presents final 1996 estimates of coverage with vaccines targeted by CII among children aged 19-35 months, *** which indicate that in 1996 all national vaccination coverage goals were exceeded for the routinely recommended vaccines. Vaccination coverage levels are monitored by CDC's National Immunization Survey (NIS), one element of the CII (1, 3-5). NIS, which was initiated in April 1994, estimates vaccination coverage among children aged 19-35 months for each of the 50 states and 28 selected urban areas (3-5). Compared with the baseline year (1992) (as measured by the National Health Interview Survey {NHIS} {6}), national vaccination coverage during the most recent reporting period (January-December 1996) increased significantly for three or more doses of diphtheria and tetanus toxoids and pertussis vaccine (DTP) (from 83% to 95%), three or more doses of poliovirus vaccine (from 72% to 91%), one or more doses of any measles-containing vaccine (MCV) (from 83% to 91%), and three or more doses of Haemophilus influenzae type b (Hib) vaccine (from 28% to 92%). Coverage with three or more doses of hepatitis B vaccine increased from 8% (CDC, unpublished data) in 1992 to 82% in 1996 (Table_1). Estimated coverage with varicella vaccine **** administered on or after the first birthday increased from 14% for July-September 1996 to 18% for October-December 1996. Compared with 1992 (6), national vaccination coverage during 1996 increased significantly for the 4:3:1 series (i.e., four or more doses of DTP/diphtheria and tetanus toxoids {DT}, three or more doses of poliovirus vaccine, and one or more doses of any MCV), from 55% to 78% (Table_1). Coverage with the 4:3:1:3 series (i.e., the 4:3:1 series plus three or more doses of Hib vaccine) increased from 72% when it was first measured in 1994 (3) to 77% in 1996 (Table_1). Overall, in 1996, a total of 30 states and 14 urban areas achieved all the 1996 CII vaccination coverage goals (Table_2). A total of 48 states and 26 urban areas achieved the 1996 goal of 90% coverage with three or more doses of DTP; the remaining two states and two urban areas attained coverage levels within two percentage points below the goal. Thirty-eight states and 17 urban areas achieved the goal of 90% coverage with three or more doses of poliovirus vaccine; 11 of the remaining 12 states and nine of the remaining 11 urban areas attained coverage of 85%-89%. Thirty-two states and 19 urban areas achieved the goal of 90% coverage with one or more doses of any MCV; 17 of the remaining 18 states and six of the remaining nine urban areas attained coverage of 85%-89%. Forty-one states and 19 urban areas achieved the goal of 90% coverage with three or more doses of Hib vaccine; seven of the remaining nine states and six of the remaining nine urban areas attained coverage levels of 85%-89%. Forty-eight states and 27 urban areas achieved the goal of 70% coverage with three or more doses of hepatitis B vaccine; one of the two remaining states and the only remaining urban area attained coverages within three percentage points below the goal. During 1996, estimated state-specific coverage levels for the 4:3:1 series ranged from 64% to 88% (median: 79%) and, for the 4:3:1:3 series, from 63% to 87% (median: 77%) (Table_3). Estimated coverage levels among selected large urban areas ranged from 63% to 84% (median: 79%) for the 4:3:1 series and from 62% to 84% (median: 75%) for the 4:3:1:3 series (Table_3). Reported by: National Center for Health Statistics; Assessment Br, Div of Data Management, National Immunization Program, CDC. Editorial NoteEditorial Note: The NIS data in this report indicate that all the national coverage goals established by CII for 1996 were exceeded for the vaccines routinely recommended for children -- specifically, three doses of DTP, three doses of poliovirus vaccine, one dose of any MCV, three doses of Hib vaccine, and three doses of hepatitis B vaccine. In addition, this report includes the first national quarterly estimates of varicella vaccination coverage. Of the coverage estimates for all the routinely recommended vaccines, estimates for varicella (the vaccine most recently added to the pediatric schedule) were the lowest, in part, because most of the children surveyed in 1996 were aged greater than 18 months before this vaccine was first recommended (7). Varicella vaccine is recommended routinely for children aged 12-18 months; however, any susceptible child can be vaccinated. The NIS data indicate that the 1996 national vaccination coverage levels for three doses of DTP, three doses of poliovirus vaccine, and one dose of any MCV increased by 12, 19, and eight percentage points, respectively, over the pre-CII coverage levels. For three doses each of hepatitis B and Hib vaccines (which had been recently recommended when CII began), coverage increased from 8% (CDC, unpublished data, 1992) to 82% for hepatitis B vaccine and from 28% to 92% for Hib vaccine. Vaccination levels among U.S. preschool-aged children were the highest ever recorded. The achievement of these goals reflects the widespread implementation of the CII strategy by multiple public- and private-sector organizations and health-care providers at national, state, and local levels (1). The findings in this report are subject to at least one important limitation. The comparison of coverage levels for 1992 and 1996 is limited by the different survey methods of the NHIS and the NIS (3,5,6). The 1992 NHIS employed an area probability sampling frame with face-to-face interviewing; in contrast, the NIS used random-digit dialing with telephone interviewing. Nonetheless, weighting adjustments of NIS data to account for nontelephone households have enabled the NIS data to be representative of all U.S. children aged 19-35 months (3,5,6). More importantly, the NIS collected information both from children's households and from their health-care providers, while the NHIS collected only household information in 1992 (3,5,6). A comparison of 1994 NHIS results with and without provider information (the first year both data sets were available) suggests that the 1992 coverage levels for DTP, poliovirus, and Hib vaccines were underestimated and that the 1992 estimate for MCV was an overestimate (3). However, the increases in national vaccination coverage levels from 1992 to 1996 could be accounted for only in part by the differences in methodology. Therefore, despite these limitations, real increases in vaccine coverage have occurred since implementation of the CII. In 1996, coverage among children with the 4:3:1 and the 4:3:1:3 series remained relatively low (78% and 77%, respectively). These findings reflect relatively low coverage with the fourth dose of DTP (81%), compared with coverage with three or more doses of poliovirus vaccine (91%), one or more doses of any MCV (91%), and three or more doses of Hib vaccine (92%). Based on these data, approximately 1 million children still need one or more of the recommended doses of vaccine to be fully protected. Although national 1996 CII coverage goals were exceeded for all individual vaccines, coverage varied substantially among states and urban areas. Many states and urban areas did not meet the 1996 CII goals for the individual vaccines, and some had not achieved even the 1995 interim goals for the individual vaccines (4). In these states and urban areas, efforts will need to be intensified to ensure the uniform protection of children throughout the United States. Achievement of the 1996 CII goals reflects substantial progress toward controlling vaccine-preventable diseases; however, achievement of these goals cannot ensure protection of children in the future. Each of the 11,000 children born each day in the United States must receive 12-16 doses of vaccine before his or her second birthday to be fully vaccinated. The achievement of the 1996 goals demonstrates the feasibility of attaining high coverage levels but does not ensure that high coverage will be maintained. Continued achievement of vaccination coverage and disease-elimination goals will require development of a fully functional vaccine-delivery system. Important components of this system remain incomplete. These components include 1) state- and community-based computerized vaccination registries that include all children from birth and can identify children in need of vaccines and recall them for missed vaccinations (8); 2) ongoing quality-assurance and information-feedback activities (9); and 3) continuous education programs for parents and health-care providers. This system should facilitate achievement and maintenance of high vaccination coverage levels and achievement of low disease levels in each cohort of children born during or after the mid-1990s. References
* Diphtheria and tetanus toxoids and pertussis vaccine/diphtheria and tetanus toxoids, poliovirus vaccine, measles-mumps-rubella vaccine (MMR), Haemophilus influenzae type b vaccine, and hepatitis B vaccine. As in previous reports based on National Immunization Survey data, MMR coverage is estimated by using coverage for any measles-containing vaccine. ** Progress toward CII's goal of eliminating or reducing the occurrence of vaccine-preventable diseases is presented in another report in this issue of MMWR (2). *** For this reporting period (January-December 1996), National Immunization Survey included children born during February 1993-May 1995 (median age: 27 months). **** Licensed by the Food and Drug Administration in 1995 and included in the recommended vaccination schedule in July 1996. Table_1 Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.
TABLE 1. Childhood Immunization Initiative (CII) goals and vaccination coverage levels
among children aged 19-35 months, by selected vaccines -- United States, 1992 and
1996
==================================================================================================
1992 (NHIS *) 1996 (NIS +)
CII 1996 --------------------- -----------------
Vaccine/Dose Goal % (95% CI &) % (95% CI)
------------------------------------------------------------------------------------------------
DTP/DT @
>=3 Doses 90% 83% (+/-2.2%) 95% (+/-0.4%)
>=4 Doses -- 59% (+/-2.9%) 81% (+/-0.7%)
Poliovirus
>=3 Doses 90% 72% (+/-2.3%) 91% (+/-0.5%)
Hib **
>=3 Doses 90% 28% (+/-2.6%) 92% (+/-0.5%)
MCV ++
>=1 Doses 90% 83% (+/-2.3%) 91% (+/-0.5%)
Hepatitis B
>=3 Doses 70% 8% && (+/-1.7%) & 82% (+/-0.7%)
Combined series
4 DTP/ 3 Polio/ 1 MCV @@ -- 55% (+/-2.8%) 78% (+/-0.8%)
4 DTP/ 3 Polio/
1 MCV/ 3 Hib *** -- -- 77% (+/-0.8%)
------------------------------------------------------------------------------------------------
* National Health Interview Survey, household data only. Children in this survey were born
during February 1989-May 1991.
+ National Immunization Survey, household and provider data. Children in this survey were
born during February 1993-May 1995.
& Confidence level.
@ Diptheria and tetanus toxoids and pertussis vaccine/diptheria and tetanus toxoids.
** Haemophilus influenzae type b vaccine.
++ Any measles-containing vaccine; vaccination coverage goals are specifically for
measles-mumps-rubella vaccine.
&& CDC, unpublished data, 1992.
@@ Four or more doses of DTP/DT, three or more doses of poliovirus vaccine, and one or more
doses of any MCV.
*** Four or more doses of DTP/DT, three or more doses of poliovirus vaccine, one or more
doses of any MCV, and three or more doses of Hib.
==================================================================================================
Return to top. Table_2 Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.
TABLE 2. Estimated vaccination coverage with individual vaccines routinely
recommended for children aged 19-35 months *, by state and selected urban area --
United States, National Immunization Survey, 1996
==========================================================================================================================================================
>=3 Hepatitis
>=3 DTP + >=4 DTP & >=3 Polio @ >=1 MCV ** >=3 Hib ++ B &&
--------------- --------------- --------------- --------------- --------------- ---------------
State/Urban area % (95% CI @@) % (95% CI) % (95% CI) % (95% CI) % (95% CI) % (95% CI)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Alabama *** 93 (+/-2.6%) 80 (+/-3.9%) 89 (+/-3.0%) 91 (+/-2.8%) 91 (+/-2.9%) 82 (+/-3.6%)
Jefferson County +++ 98 (+/-1.6%) 84 (+/-4.2%) 90 (+/-3.5%) 94 (+/-2.8%) 94 (+/-2.8%) 87 (+/-3.9%)
Alaska *** 90 (+/-3.8%) 76 (+/-5.2%) 88 (+/-4.1%) 85 (+/-4.4%) 84 (+/-4.5%) 82 (+/-4.3%)
Arizona *** 93 (+/-2.2%) 75 (+/-3.7%) 89 (+/-2.7%) 86 (+/-3.1%) 90 (+/-2.6%) 80 (+/-3.2%)
Maricopa County *** 92 (+/-3.3%) 75 (+/-5.0%) 89 (+/-3.6%) 87 (+/-3.9%) 89 (+/-3.7%) 81 (+/-4.4%)
Arkansas *** 93 (+/-3.3%) 78 (+/-5.1%) 91 (+/-3.6%) 87 (+/-4.2%) 86 (+/-4.5%) 82 (+/-4.4%)
California +++ 94 (+/-1.8%) 81 (+/-2.9%) 91 (+/-2.1%) 90 (+/-2.2%) 90 (+/-2.3%) 82 (+/-2.5%)
Santa Clara +++ 96 (+/-2.0%) 86 (+/-3.8%) 94 (+/-2.5%) 92 (+/-2.9%) 92 (+/-3.0%) 85 (+/-3.7%)
San Diego County *** 93 (+/-2.9%) 82 (+/-4.1%) 89 (+/-3.4%) 93 (+/-2.7%) 91 (+/-3.3%) 82 (+/-4.1%)
Los Angeles +++ 94 (+/-2.9%) 83 (+/-4.6%) 91 (+/-3.4%) 91 (+/-3.5%) 91 (+/-3.7%) 83 (+/-4.3%)
Colorado *** 94 (+/-2.8%) 82 (+/-4.5%) 91 (+/-3.5%) 89 (+/-3.7%) 91 (+/-3.4%) 74 (+/-5.0%)
Connecticut +++ 99 (+/-0.9%) 90 (+/-3.3%) 95 (+/-2.5%) 96 (+/-2.0%) 98 (+/-1.3%) 89 (+/-3.5%)
Delaware +++ 97 (+/-2.1%) 85 (+/-4.1%) 93 (+/-3.0%) 90 (+/-3.5%) 95 (+/-2.6%) 85 (+/-4.0%)
District of Columbia +++ 98 (+/-1.9%) 83 (+/-4.6%) 94 (+/-2.9%) 94 (+/-2.8%) 93 (+/-3.0%) 84 (+/-4.3%)
Florida +++ 96 (+/-1.9%) 80 (+/-3.8%) 92 (+/-2.6%) 90 (+/-2.9%) 92 (+/-2.5%) 83 (+/-3.3%)
Dade County +++ 98 (+/-1.7%) 82 (+/-4.7%) 94 (+/-3.0%) 93 (+/-3.1%) 93 (+/-3.0%) 80 (+/-4.8%)
Duval County +++ 96 (+/-2.3%) 79 (+/-4.9%) 93 (+/-3.1%) 91 (+/-3.4%) 94 (+/-2.8%) 83 (+/-4.4%)
Georgia +++ 96 (+/-1.9%) 85 (+/-3.3%) 94 (+/-2.2%) 92 (+/-2.6%) 92 (+/-2.6%) 87 (+/-2.8%)
Fulton/DeKalb +++
counties 97 (+/-1.9%) 83 (+/-4.8%) 93 (+/-3.1%) 93 (+/-3.2%) 92 (+/-3.4%) 82 (+/-4.8%)
Hawaii +++ 93 (+/-3.1%) 81 (+/-4.6%) 91 (+/-3.4%) 92 (+/-3.2%) 91 (+/-3.3%) 86 (+/-4.0%)
Idaho *** 89 (+/-3.5%) 71 (+/-4.8%) 86 (+/-3.8%) 84 (+/-4.0%) 86 (+/-3.8%) 72 (+/-4.5%)
Illinois *** 94 (+/-2.3%) 79 (+/-3.6%) 89 (+/-2.8%) 90 (+/-2.6%) 91 (+/-2.6%) 78 (+/-3.4%)
Chicago *** 96 (+/-2.5%) 79 (+/-5.2%) 88 (+/-4.2%) 90 (+/-3.6%) 90 (+/-4.0%) 75 (+/-5.5%)
Indiana *** 94 (+/-2.2%) 77 (+/-3.7%) 90 (+/-2.6%) 87 (+/-3.1%) 89 (+/-2.9%) 74 (+/-3.5%)
Marion County *** 91 (+/-3.7%) 75 (+/-5.3%) 87 (+/-4.1%) 88 (+/-4.0%) 89 (+/-3.9%) 77 (+/-4.9%)
Iowa +++ 97 (+/-2.0%) 84 (+/-3.9%) 94 (+/-2.6%) 92 (+/-2.9%) 94 (+/-2.5%) 81 (+/-4.1%)
Kansas *** 92 (+/-3.2%) 78 (+/-4.5%) 87 (+/-3.8%) 88 (+/-3.5%) 89 (+/-3.6%) 73 (+/-4.7%)
Kentucky +++ 95 (+/-2.7%) 81 (+/-4.5%) 92 (+/-3.2%) 91 (+/-3.4%) 92 (+/-3.1%) 86 (+/-3.9%)
Louisiana *** 95 (+/-2.3%) 83 (+/-3.7%) 92 (+/-2.8%) 89 (+/-3.1%) 94 (+/-2.5%) 87 (+/-3.3%)
Orleans Parish *** 94 (+/-3.4%) 74 (+/-5.8%) 86 (+/-4.6%) 86 (+/-4.7%) 93 (+/-3.5%) 82 (+/-4.9%)
Maine +++ 98 (+/-1.3%) 91 (+/-2.7%) 94 (+/-2.5%) 95 (+/-2.1%) 95 (+/-2.1%) 75 (+/-4.4%)
Maryland +++ 97 (+/-1.5%) 83 (+/-3.6%) 92 (+/-2.6%) 91 (+/-2.8%) 95 (+/-1.8%) 80 (+/-3.6%)
Baltimore +++ 95 (+/-2.7%) 87 (+/-4.2%) 91 (+/-3.7%) 93 (+/-3.2%) 91 (+/-3.5%) 78 (+/-5.1%)
Massachusetts +++ 98 (+/-1.3%) 88 (+/-3.0%) 94 (+/-2.2%) 96 (+/-1.6%) 96 (+/-1.7%) 88 (+/-2.8%)
Boston +++ 97 (+/-1.9%) 88 (+/-3.6%) 93 (+/-3.0%) 94 (+/-2.6%) 97 (+/-1.9%) 90 (+/-3.4%)
Michigan +++ 94 (+/-2.1%) 78 (+/-3.8%) 90 (+/-2.8%) 90 (+/-2.8%) 91 (+/-2.6%) 78 (+/-3.5%)
Detroit &&& 88 (+/-4.2%) 67 (+/-6.1%) 82 (+/-5.1%) 83 (+/-4.9%) 81 (+/-5.2%) 69 (+/-6.0%)
Minnesota +++ 97 (+/-1.6%) 89 (+/-3.2%) 92 (+/-2.9%) 95 (+/-2.1%) 94 (+/-2.5%) 72 (+/-4.7%)
Mississippi +++ 96 (+/-2.1%) 83 (+/-4.0%) 93 (+/-2.8%) 93 (+/-2.8%) 93 (+/-2.8%) 78 (+/-4.5%)
Missouri *** 92 (+/-3.2%) 77 (+/-4.7%) 89 (+/-3.6%) 87 (+/-3.7%) 91 (+/-3.3%) 82 (+/-4.1%)
Montana *** 95 (+/-2.4%) 80 (+/-4.2%) 90 (+/-3.2%) 89 (+/-3.3%) 93 (+/-2.8%) 77 (+/-4.3%)
Nebraska +++ 96 (+/-2.0%) 84 (+/-3.7%) 94 (+/-2.4%) 91 (+/-3.0%) 93 (+/-2.6%) 78 (+/-4.3%)
Nevada *** 91 (+/-3.5%) 74 (+/-5.2%) 87 (+/-4.0%) 86 (+/-4.2%) 89 (+/-3.7%) 82 (+/-4.3%)
New Hampshire +++ 97 (+/-1.6%) 86 (+/-3.8%) 90 (+/-3.3%) 94 (+/-2.6%) 95 (+/-2.3%) 86 (+/-3.5%)
New Jersey +++ 97 (+/-2.0%) 82 (+/-4.2%) 90 (+/-3.4%) 90 (+/-3.4%) 92 (+/-2.9%) 87 (+/-3.5%)
Newark *** 95 (+/-2.9%) 67 (+/-6.1%) 84 (+/-4.9%) 87 (+/-4.4%) 90 (+/-3.9%) 80 (+/-5.0%)
New Mexico +++ 95 (+/-2.6%) 82 (+/-4.6%) 92 (+/-3.2%) 92 (+/-3.2%) 93 (+/-3.1%) 80 (+/-4.3%)
New York +++ 98 (+/-1.3%) 86 (+/-3.0%) 93 (+/-2.3%) 94 (+/-2.0%) 93 (+/-2.3%) 83 (+/-3.1%)
New York City +++ 97 (+/-2.3%) 85 (+/-4.6%) 90 (+/-3.9%) 92 (+/-3.4%) 90 (+/-4.0%) 80 (+/-4.9%)
North Carolina *** 96 (+/-2.4%) 81 (+/-4.4%) 94 (+/-2.6%) 89 (+/-3.5%) 92 (+/-3.1%) 87 (+/-3.5%)
North Dakota +++ 96 (+/-2.3%) 86 (+/-3.7%) 92 (+/-3.0%) 90 (+/-3.3%) 93 (+/-2.8%) 85 (+/-3.7%)
Ohio +++ 96 (+/-1.7%) 82 (+/-3.1%) 91 (+/-2.4%) 93 (+/-2.0%) 93 (+/-2.0%) 81 (+/-3.1%)
Cuyahoga County +++ 96 (+/-2.3%) 83 (+/-4.4%) 93 (+/-3.2%) 94 (+/-2.7%) 94 (+/-2.8%) 86 (+/-3.9%)
Franklin County +++ 95 (+/-3.1%) 83 (+/-5.0%) 90 (+/-4.2%) 93 (+/-3.5%) 91 (+/-4.0%) 78 (+/-5.3%)
Oklahoma *** 93 (+/-3.4%) 79 (+/-5.2%) 90 (+/-3.8%) 89 (+/-4.0%) 90 (+/-3.8%) 71 (+/-5.5%)
Oregon *** 92 (+/-3.1%) 74 (+/-4.8%) 87 (+/-3.8%) 86 (+/-3.9%) 89 (+/-3.5%) 78 (+/-4.3%)
Pennsylvania +++ 96 (+/-1.8%) 83 (+/-3.5%) 94 (+/-2.2%) 92 (+/-2.6%) 93 (+/-2.4%) 84 (+/-3.3%)
Philadelphia *** 96 (+/-2.5%) 82 (+/-4.8%) 93 (+/-3.1%) 91 (+/-3.6%) 88 (+/-4.2%) 89 (+/-3.8%)
Rhode Island +++ 100 (+/-0.1%) 88 (+/-3.5%) 96 (+/-2.1%) 96 (+/-2.1%) 98 (+/-1.5%) 90 (+/-3.2%)
South Carolina +++ 99 (+/-1.1%) 87 (+/-3.7%) 97 (+/-1.5%) 95 (+/-2.3%) 97 (+/-1.8%) 93 (+/-2.3%)
South Dakota +++ 96 (+/-2.2%) 84 (+/-3.8%) 92 (+/-2.9%) 92 (+/-2.7%) 94 (+/-2.6%) 72 (+/-4.9%)
Tennessee +++ 95 (+/-1.6%) 82 (+/-2.8%) 92 (+/-1.9%) 90 (+/-2.3%) 92 (+/-2.0%) 85 (+/-2.6%)
Davidson County +++ 95 (+/-2.4%) 84 (+/-4.2%) 90 (+/-3.4%) 91 (+/-3.4%) 92 (+/-3.2%) 82 (+/-4.3%)
Shelby County *** 90 (+/-3.8%) 75 (+/-5.1%) 86 (+/-4.2%) 85 (+/-4.3%) 87 (+/-4.1%) 84 (+/-4.0%)
Texas *** 92 (+/-2.1%) 78 (+/-3.2%) 89 (+/-2.6%) 89 (+/-2.3%) 89 (+/-2.5%) 82 (+/-2.7%)
Bexar County *** 95 (+/-2.6%) 77 (+/-5.0%) 91 (+/-3.3%) 89 (+/-3.6%) 92 (+/-3.2%) 83 (+/-3.9%)
Dallas County *** 93 (+/-3.5%) 78 (+/-5.4%) 91 (+/-3.7%) 91 (+/-3.7%) 88 (+/-4.4%) 81 (+/-4.9%)
El Paso County *** 90 (+/-3.8%) 67 (+/-5.6%) 88 (+/-3.9%) 82 (+/-4.7%) 84 (+/-4.5%) 80 (+/-4.6%)
Houston *** 89 (+/-4.2%) 73 (+/-5.8%) 87 (+/-4.3%) 84 (+/-4.8%) 84 (+/-4.9%) 79 (+/-4.9%)
Utah *** 88 (+/-3.9%) 67 (+/-5.3%) 84 (+/-4.3%) 86 (+/-4.0%) 84 (+/-4.3%) 72 (+/-4.9%)
Vermont +++ 97 (+/-1.6%) 88 (+/-3.2%) 95 (+/-2.0%) 93 (+/-2.6%) 95 (+/-2.2%) 83 (+/-3.6%)
Virginia +++ 97 (+/-2.1%) 81 (+/-4.7%) 91 (+/-3.4%) 90 (+/-3.7%) 94 (+/-2.8%) 85 (+/-3.9%)
Washington +++ 95 (+/-1.9%) 81 (+/-3.4%) 92 (+/-2.4%) 91 (+/-2.4%) 94 (+/-2.1%) 81 (+/-3.3%)
King County +++ 97 (+/-1.9%) 84 (+/-4.1%) 94 (+/-2.5%) 95 (+/-2.3%) 96 (+/-2.2%) 84 (+/-4.0%)
West Virginia &&& 96 (+/-2.4%) 75 (+/-5.0%) 88 (+/-3.8%) 88 (+/-3.8%) 92 (+/-3.3%) 67 (+/-5.2%)
Wisconsin +++ 95 (+/-1.8%) 82 (+/-3.1%) 91 (+/-2.3%) 90 (+/-2.5%) 92 (+/-2.2%) 79 (+/-3.3%)
Milwaukee County *** 93 (+/-3.0%) 77 (+/-4.9%) 89 (+/-3.7%) 91 (+/-3.3%) 87 (+/-3.9%) 75 (+/-4.9%)
Wyoming &&& 94 (+/-2.6%) 82 (+/-4.2%) 91 (+/-3.1%) 89 (+/-3.5%) 93 (+/-2.8%) 57 (+/-5.1%)
Total 95 (+/-0.4%) 81 (+/-0.7%) 91 (+/-0.5%) 91 (+/-0.5%) 92 (+/-0.5%) 82 (+/-0.7%)
--------------------------------------------------------------------------------------------------------------------------------------------------------
* Children in this age group were born during February 1993 -- May 1995.
+ Three or more doses of diphtheria and tetanus toxoids and pertussis vaccine/diphtheria and tetanus
toxoids (DTP/DT).
& Four or more doses of DTP/DT.
@ Three or more doses of poliovirus vaccine.
** One or more doses of any measles-containing vaccine.
++ Three or more doses of Haemophilus influenzae type b vaccine.
&& Three or more doses of hepatitis B vaccine.
@@ Confidence interval.
*** Did not achieve the 1996 Childhood Immunization Initiative (CII) goals for at least one of the following:
three or more doses of DTP, three or more doses of poliovirus vaccine, one or more doses of MMR, or
three or more doses of Hib, but achieved the 1996 goal for three or more doses of hepatitis B vaccine.
+++ Achieved the 1996 CII goals for three or more doses of DTP, three or more doses of poliovirus vaccine,
one or more doses of MMR, three or more doses of Hib, and three or more doses of hepatitis B vaccine.
&&& Did not achieve the 1996 CII goals for at least one of the following: three or more doses of DTP, three
or more doses of poliovirus vaccine, one or more doses of MMR, or three or more doses of Hib, and
did not achieve the 1996 goal for three or more doses of hepatitis B vaccine.
==========================================================================================================================================================
Return to top. Table_3 Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.
TABLE 3. Estimated vaccination coverage with the 4:3:1 series * and the 4:3:1:3 series +
among children aged 19-35 months &, by coverage level and state and selected urban
area -- United States, National Immunization Survey, 1996
=============================================================================================================
4:3:1 Series � 4:3:1:3 Series
Coverage level/ -------------- � Coverage level/ ---------------
State/Urban area % (95% CI @) � State/Urban area % (95% CI)
--------------------------------------------------+--------------------------------------------------
>=85% � >=85%
Connecticut 88 (+/-3.6%) � Connecticut 87 (+/-3.7%)
Maine 87 (+/-3.4%) � Maine 85 (+/-3.6%)
Massachusetts 87 (+/-3.1%) � Massachusetts 86 (+/-3.2%)
Boston 84 (+/-4.2%) � Boston 84 (+/-4.2%)
Minnesota 85 (+/-3.6%) � Rhode Island 85 (+/-3.9%)
Rhode Island 85 (+/-3.8%) � Vermont 85 (+/-3.4%)
South Carolina 86 (+/-3.7%) �
Vermont 86 (+/-3.3%) � 75%-84%
� Alabama 75 (+/-4.1%)
75%-84% � Jefferson County 77 (+/-4.8%)
Alabama 78 (+/-4.0%) � California 76 (+/-3.1%)
Jefferson County 80 (+/-4.6%) � Los Angeles County 79 (+/-4.9%)
Arkansas 75 (+/-5.2%) � San Diego County 77 (+/-4.4%)
California 78 (+/-3.0%) � Santa Clara 79 (+/-4.4%)
Los Angeles County 81 (+/-4.8%) � Colorado 76 (+/-5.0%)
San Diego County 78 (+/-4.3%) � Delaware 80 (+/-4.6%)
Santa Clara 82 (+/-4.2%) � District of Columbia 78 (+/-5.0%)
Colorado 79 (+/-4.8%) � Florida 77 (+/-3.9%)
Delaware 81 (+/-4.5%) � Dade County 76 (+/-5.2%)
District of Columbia 80 (+/-4.8%) � Duval County 76 (+/-5.1%)
Florida 78 (+/-3.8%) � Georgia 80 (+/-3.6%)
Dade County 79 (+/-4.9%) � Fulton/DeKalb counties 74 (+/-5.5%)
Duval County 77 (+/-5.1%) � Hawaii 77 (+/-4.8%)
Georgia 83 (+/-3.4%) � llinois 75 (+/-3.7%)
Fulton/DeKalb counties 79 (+/-5.1%) � Chicago 74 (+/-5.6%)
Hawaii 78 (+/-4.8%) � Iowa 80 (+/-4.2%)
Illinois 76 (+/-3.7%) � Kentucky 76 (+/-4.8%)
Chicago 76 (+/-5.4%) � Louisiana 79 (+/-4.0%)
Iowa 82 (+/-4.1%) � Orleans Parish 71 (+/-5.9%)
Kansas 76 (+/-4.6%) � Maryland 78 (+/-4.0%)
Kentucky 79 (+/-4.7%) � Baltimore 81 (+/-4.8%)
Louisiana 80 (+/-3.9%) � Minnesota 83 (+/-3.8%)
Orleans Parish 72 (+/-5.9%) � Mississippi 79 (+/-4.3%)
Maryland 80 (+/-3.9%) � Montana 77 (+/-4.3%)
Baltimore 84 (+/-4.5%) � Nebraska 80 (+/-3.9%)
Michigan 76 (+/-3.8%) � New Hampshire 83 (+/-4.0%)
Detroit 65 (+/-6.1%) � New Jersey 77 (+/-4.5%)
Mississippi 81 (+/-4.2%) � Newark 62 (+/-6.2%)
Missouri 75 (+/-4.8%) � New Mexico 79 (+/-4.8%)
Montana 78 (+/-4.3%) � New York 79 (+/-3.5%)
Nebraska 82 (+/-3.8%) � New York City 75 (+/-5.5%)
New Hampshire 84 (+/-3.9%) � North Carolina 77 (+/-4.7%)
New Jersey 78 (+/-4.5%) � North Dakota 81 (+/-4.2%)
Newark 63 (+/-6.2%) � Ohio 77 (+/-3.4%)
New Mexico 80 (+/-4.7%) � Cuyahoga County 80 (+/-4.7%)
New York 82 (+/-3.3%) � Franklin County 78 (+/-5.4%)
New York City 80 (+/-5.1%) � Pennsylvania 79 (+/-3.7%)
North Carolina 78 (+/-4.6%) � Philadelphia 75 (+/-5.4%)
North Dakota 83 (+/-4.0%) � South Carolina 84 (+/-3.9%)
Ohio 79 (+/-3.3%) � South Dakota 80 (+/-4.1%)
Cuyahoga County 81 (+/-4.5%) � Tennessee 77 (+/-3.0%)
Franklin County 81 (+/-5.2%) � Davidson County 77 (+/-4.7%)
Oklahoma 75 (+/-5.5%) � Shelby County 70 (+/-5.3%)
Pennsylvania 81 (+/-3.6%) � Virginia 77 (+/-5.0%)
Philadelphia 79 (+/-5.1%) � Washington 78 (+/-3.5%)
South Dakota 82 (+/-3.9%) � King County 81 (+/-4.2%)
Tennessee 79 (+/-2.9%) � Wisconsin 76 (+/-3.4%)
Davidson County 79 (+/-4.5%) � Milwaukee County 70 (+/-5.2%)
Shelby County 72 (+/-5.3%) � Wyoming 77 (+/-4.5%)
Virginia 78 (+/-4.9%) �
Washington 79 (+/-3.5%) � 65%-74%
King County 82 (+/-4.1%) � Alaska 69 (+/-5.5%)
Wisconsin 78 (+/-3.3%) � Arizona 70 (+/-3.8%)
Milwaukee County 74 (+/-5.0%) � Maricopa County 71 (+/-5.1%)
Wyoming 79 (+/-4.4%) � Arkansas 72 (+/-5.4%)
� Idaho 66 (+/-4.9%)
65%-74% � Indiana 70 (+/-3.9%)
Alaska 73 (+/-5.3%) � Marion County 72 (+/-5.4%)
Arizona 72 (+/-3.8%) � Kansas 73 (+/-4.7%)
Maricopa County 73 (+/-5.0%) � Michigan 74 (+/-3.9%)
Idaho 68 (+/-4.9%) � Detroit 63 (+/-6.1%)
Indiana 73 (+/-3.9%) � Missouri 74 (+/-4.9%)
Marion County 73 (+/-5.3%) � Nevada 70 (+/-5.3%)
Nevada 71 (+/-5.3%) � Oklahoma 73 (+/-5.6%)
Oregon 72 (+/-4.9%) � Oregon 70 (+/-5.0%)
Texas 74 (+/-3.4%) � Texas 72 (+/-3.4%)
Bexar County 74 (+/-5.1%) � Bexar County 74 (+/-5.2%)
Dallas County 75 (+/-5.6%) � Dallas County 71 (+/-5.8%)
El Paso County 64 (+/-5.6%) � El Paso County 62 (+/-5.6%)
Houston 71 (+/-5.8%) � Houston 68 (+/-5.9%)
West Virginia 72 (+/-5.1%) � West Virginia 71 (+/-5.1%)
�
<65% � <65%
Utah 64 (+/-5.3%) � Utah 63 (+/-5.3%)
�
Total 78 (+/-0.8%) � Total 77 (+/-0.8%)
--------------------------------------------------+--------------------------------------------------
* Four or more doses of diphtheria and tetanus toxoids and pertussis vaccine/diphtheria and tetanus toxoids
(DTP/DT), three or more doses of poliovirus vaccine, and one or more doses of any measles-containing
vaccine (MCV).
+ Four or more doses of DTP/DT, three or more doses of poliovirus vaccine, one or more doses of any MCV,
and three or more doses of Haemophilus influenzae type b vaccine.
& Children in this age group during 1996 were born during February 1993 -- May 1995.
@ Confidence interval.
=============================================================================================================
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