Low vaccination levels of US preschool and school-age children. Retrospective assessments of vaccination coverage, 1991-1992.

OBJECTIVE

To obtain estimates on (1) the percentage of children who were up-to-date on the recommended childhood vaccination series, (2) the percentage of children who were age-appropriately immunized, and (3) coverage levels by individual vaccines.

DESIGN

Vaccination levels were estimated by conducting retrospective immunization coverage surveys of the school health records of children entering kindergarten or first grade in the 1990-1991 or 1991-1992 school year. A multistage cluster survey design was used.

SETTING

Survey sites were selected from among the 60 largest urban areas in the United States. One small city and one rural area were selected for comparison.

RESULTS

By their second birthday, 11% to 58% (median, 44%) of the children were fully vaccinated. Stricter measurement criteria lowered coverage levels further. Completed series levels at school entry were 71% to 96% (median, 87%).

CONCLUSIONS

Vaccination levels at the second birthday were far below the goal for the year 2000. All health providers need to administer vaccines according to the recommended schedule.