MMWR Morb Mortal Wkly Rep. 2015 Aug 28;64(33):889-96. doi: 10.15585/mmwr.mm6433a1.
The reduction in morbidity and mortality associated with vaccine-preventable diseases in the United States has been described as one of the 10 greatest public health achievements of the first decade of the 21st century. A recent analysis concluded that routine childhood vaccination will prevent 322 million cases of disease and about 732,000 early deaths among children born during 1994-2013, for a net societal cost savings of $1.38 trillion. The National Immunization Survey (NIS) has monitored vaccination coverage among U.S. children aged 19-35 months since 1994. This report presents national, regional, state, and selected local area vaccination coverage estimates for children born from January 2011 through May 2013, based on data from the 2014 NIS. For most vaccinations, there was no significant change in coverage between 2013 and 2014. The exception was hepatitis A vaccine (HepA), for which increases were observed in coverage with both ≥1 and ≥2 doses. As in previous years, <1% of children received no vaccinations. National coverage estimates indicate that the Healthy People 2020 target* of 90% was met for ≥3 doses of poliovirus vaccine (93.3%), ≥1 dose of measles, mumps, and rubella vaccine (MMR) (91.5%), ≥3 doses of hepatitis B vaccine (HepB) (91.6%), and ≥1 dose of varicella vaccine (91.0%). Coverage was below target for ≥4 doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP), the full series of Haemophilus influenzae type b (Hib) vaccine, hepatitis B (HepB) birth dose,† ≥4 doses pneumococcal conjugate vaccine (PCV), ≥2 doses of HepA, the full series of rotavirus vaccine, and the combined vaccine series.§ Examination of coverage by child's race/ethnicity revealed lower estimated coverage among non-Hispanic black children compared with non-Hispanic white children for several vaccinations, including DTaP, the full series of Hib, PCV, rotavirus vaccine, and the combined series. Children from households classified as below the federal poverty level had lower estimated coverage for almost all of the vaccinations assessed, compared with children living at or above the poverty level. Significant variation in coverage by state¶ was observed for several vaccinations, including HepB birth dose, HepA, and rotavirus. High vaccination coverage must be maintained across geographic and sociodemographic groups if progress in reducing the impact of vaccine-preventable diseases is to be sustained.
预防疫苗可预防疾病的发病率和死亡率的降低，被描述为 21 世纪第一个十年的 10 项最伟大的公共卫生成就之一。最近的一项分析得出结论，常规儿童疫苗接种将预防 1994 年至 2013 年期间出生的儿童 3.22 亿例疾病和约 73.2 万例早期死亡，为社会节省了 1.38 万亿美元。自 1994 年以来，国家免疫调查（NIS）一直在监测美国 19-35 个月大儿童的疫苗接种覆盖率。本报告根据 2014 年 NIS 的数据，提供了 2011 年 1 月至 2013 年 5 月期间出生的儿童的全国、地区、州和选定的当地疫苗接种覆盖率估计数。对于大多数疫苗接种，2013 年和 2014 年之间的覆盖率没有显著变化。唯一的例外是甲型肝炎疫苗（HepA），无论是≥1 剂还是≥2 剂，其覆盖率都有所增加。与往年一样，<1%的儿童没有接种任何疫苗。全国覆盖率估计表明，健康人 2020 年的目标*90%达到了，≥3 剂脊髓灰质炎疫苗（93.3%）、≥1 剂麻疹、腮腺炎和风疹疫苗（MMR）（91.5%）、≥3 剂乙型肝炎疫苗（HepB）（91.6%）和≥1 剂水痘疫苗（91.0%）。对于≥4 剂白喉、破伤风和无细胞百日咳疫苗（DTaP）、全系列流感嗜血杆菌 b 型（Hib）疫苗、乙型肝炎（HepB）出生剂量、†≥4 剂肺炎球菌结合疫苗（PCV）、≥2 剂 HepA、全系列轮状病毒疫苗和联合疫苗系列，覆盖率低于目标。对儿童种族/族裔的覆盖率检查显示，与非西班牙裔白人儿童相比，非西班牙裔黑人儿童的某些疫苗接种率估计较低，包括 DTaP、全系列 Hib、PCV、轮状病毒疫苗和联合系列。来自家庭收入低于联邦贫困线的儿童的疫苗接种覆盖率估计几乎所有评估的疫苗接种率都较低，与生活在贫困线或以上的儿童相比。在几项疫苗接种中，包括乙型肝炎疫苗出生剂量、甲型肝炎疫苗和轮状病毒疫苗，州之间的覆盖率存在显著差异。如果要保持减少疫苗可预防疾病影响的进展，则必须在地理和社会人口群体之间保持高疫苗接种率。
