Herrera G A, Smith P, Daniels D, Klevens R M, Coronado V, McCauley M, Stokley S, Maes E F, Ezzati-Rice T M, Wright R A, Cordero J F
Assessment Branch, Division of Data Management, National Immunization Program, USA.
MMWR CDC Surveill Summ. 2000 Sep 22;49(9):1-26.
PROBLEM/CONDITION: High vaccination levels in the population are necessary to decrease disease transmission and prevent disease; therefore, an important component of the U.S. vaccination program is the assessment of vaccination coverage. Current goals are for > or = 90% coverage with recommended vaccines during the first 2 years of life.
January-December 1998.
The National Immunization Survey (NIS) is an ongoing, random-digit-dialed telephone survey that gathers vaccination coverage data for children aged 19-35 months in all 50 states and 28 urban areas. Vaccination coverage rates derived from NIS data are adjusted statistically for households with multiple telephone lines, household nonresponse, the proportion of households without telephones, and vaccination provider nonresponse. The results were also adjusted to match the known total population of children in each survey area.
On the basis of NIS data, national coverage was > or = 90% for three doses of poliovirus vaccine (Polio), three doses of Haemophilus influenzae type b vaccine (Hib), and one dose of measles-containing vaccine (MCV). Coverage was the highest ever reported for four doses of any diphtheria and tetanus toxoids and pertussis vaccine (DTP) (i.e., diphtheria and tetanus toxoids and pertussis vaccine, diphtheria and tetanus toxoids [DT], or diphtheria and tetanus toxoids and acellular pertussis vaccine [DTaP]) (83.9%), three doses of hepatitis B vaccine (Hep B, 87.0%), and one dose of varicella vaccine (43.2%). The number of states achieving the > or = 90% goal was 47 for three doses of Hib, 40 for three doses of Polio, 40 for one dose of MCV, nine for three doses of Hep B, and seven for four doses of DTP. Proportionally fewer urban areas achieved the > or = 90% goal: 23 of 28 for three doses of Hib, 13 for three doses of Polio, 16 for one dose of MCV, five for three doses of Hep B, and one for four doses of DTP. No state or urban area has yet achieved the > or = 90% goal for varicella.
Findings from the 1998 NIS indicate that national vaccination coverage levels for routinely recommended childhood vaccines are at the highest levels ever reported. However, substantial variation in coverage remains at the state and urban area levels.
The public health community and vaccination providers in areas with low coverage should intensify their efforts to implement recommended strategies for increasing vaccination coverage to ensure that children are equally well protected throughout the United States.
问题/状况：人群中高疫苗接种率对于减少疾病传播和预防疾病是必要的；因此，美国疫苗接种计划的一个重要组成部分是对接种覆盖率的评估。当前目标是在生命的头两年内，推荐疫苗的接种覆盖率达到或超过90%。
1998年1月至12月。
国家免疫调查（NIS）是一项持续进行的随机数字拨号电话调查，收集全美50个州和28个城市地区19至35个月龄儿童的疫苗接种覆盖率数据。根据NIS数据得出的疫苗接种覆盖率会针对有多条电话线的家庭、家庭无应答情况、无电话家庭的比例以及疫苗接种提供者无应答情况进行统计学调整。结果还进行了调整，以匹配每个调查地区已知的儿童总人口。
根据NIS数据，三剂脊髓灰质炎疫苗（脊灰疫苗）、三剂b型流感嗜血杆菌疫苗（Hib）和一剂含麻疹疫苗（MCV）的全国覆盖率达到或超过90%。四剂白喉破伤风类毒素和百日咳疫苗（DTP）（即白喉破伤风类毒素和百日咳疫苗、白喉破伤风类毒素[DT]或白喉破伤风类毒素和无细胞百日咳疫苗[DTaP]）的覆盖率为有记录以来最高（83.9%），三剂乙型肝炎疫苗（乙肝疫苗，87.0%）和一剂水痘疫苗的覆盖率为（43.2%）达到或超过90%目标的州数量，三剂Hib为47个，三剂脊灰疫苗为40个，一剂MCV为40个，三剂乙肝疫苗为9个,四剂DTP为7个。按比例计算，达到或超过90%目标的城市地区较少：三剂Hib在28个城市地区中有23个，三剂脊灰疫苗有13个,一剂MCV有16个,三剂乙肝疫苗有5个,四剂DTP有1个。尚无州或城市地区达到水痘疫苗90%或更高的目标。
1998年NIS的结果表明，常规推荐的儿童疫苗全国接种覆盖率处于有记录以来的最高水平。然而，州和城市地区层面的覆盖率仍存在显著差异。
覆盖率较低地区的公共卫生界和疫苗接种提供者应加大力度实施推荐的提高疫苗接种覆盖率的策略，以确保美国各地的儿童都能得到同样良好保护
