Important Facts for Immunizations: recommended immunizations by age 24 months

Definition

Children aged 24 months who received the recommended vaccines (4 DTaP, 3 Polio, 1 MMR, 3 Hep B, Hib full series, 1 Varicella, and 4 PCV).

Numerator

Number of survey respondents aged 24 months that have received at least 4 doses of DTaP, 3 doses of Polio, 1 dose of MMR, 3 doses of Hep B, 3 or 4 doses of Hib (depending on product type), 1 dose of Varicella, and 4 Pneumococcal.

Denominator

Total survey respondents aged 24 months.

Data Interpretation Issues

The National Immunization Survey (NIS) is conducted by the Centers for Disease Control and Prevention (CDC) and uses a random-digit-dialing sample of landline and cellular telephone numbers to find households throughout the U.S. with children who are or will be 19-35 months within a few weeks of being selected to participate in the survey. Data are used to monitor vaccination coverage among 2-year-old children at the national, state, selected local levels, and some in U.S. territories. Interviewers ask parents or guardians to tell them which vaccines (with dates) appear on the child's "shot card" kept in the home, and they also collect demographic and socioeconomic information. At the end of the interview, they ask for permission to contact the child's vaccination providers. Vaccine providers are then contacted by mail to verify each child's vaccinations. The NIS uses a nationally representative sample, and provides estimates of coverage that are weighted to represent the entire population, nationally, and by region, state, and selected large metro areas. The large sample size (approximately 15,000) allows them to stratify (that is, subdivide) the data so that they can examine vaccination rates among different groups, for instance by income level, race, education level of mothers, and other factors. In previous years NIS Child data was reported for 19-35 month old children by survey year. However, in 2019 NIS began reporting immunization estimates based on the birth year. At the time of the change, the birth year estimates were made available back to birth year 2013 and are displayed in an accompanying data view in this Indicator Report.

Why Is This Important?

Immunizations are the most cost-effective health prevention measures. Development of vaccinations had been cited by the U.S. Public Health Service as one of the Ten Great Public Health Achievements in the 20th Century^1^. Vaccines play an essential role in reducing and eliminating disease. By two years of age, it is recommended that all children should have received 4 doses of Diphtheria-Tetanus-Pertussis (DTP), 3 doses of Polio, 1 dose of Measles-Mumps-Rubella (MMR), 3 doses of Hepatitis B, full series of ''Haemophilus influenzae'' type B (Hib) (3 of 4 doses depending on product type received), 1 dose of Varicella, and 4 doses of Pneumococcal vaccines. This recommendation is referred to in shorthand as "4:3:1:3:3:1:4." [[br]][[br]] ---- 1. Centers for Disease Control and Prevention. (1999). Achievements in Public Health, 1900-1999: Impact of vaccines universally recommended for children -- United States 1990-1998. ''Morbidity and Mortality Weekly Report,'' Vol. 48, (12);243-248. Atlanta, GA.

Other Objectives

Utah's 42 Community Health Indicators ===Healthy People 2030 related objectives:=== IID-02: Reduce the proportion of children who get no recommended vaccines by age 2 years[[br]] '''U.S. Target:''' 1.3 percent [[br]][[br]] IID-03: Maintain the vaccination coverage level of 1 dose of the MMR vaccine in children by age 2 years[[br]] '''U.S. Target:''' 90.8 percent [[br]][[br]] IID-04: Maintain the vaccination coverage level of 2 doses of the MMR vaccine for children in kindergarten[[br]] '''U.S. Target:''' 95.0 percent [[br]][[br]] IID-06: Increase the coverage level of 4 doses of the DTaP vaccine in children by age 2 years [[br]] '''U.S. Target:''' 90.0 percent

How Are We Doing?

Coverage levels in Utah have generally increased in the past 8 years from 67.2% of 2-year-old children fully immunized in 2013 to 79.0% in 2020. It should be noted that the estimate for this measure decreased from 79.0% in 2020 to 74.9% in 2023. However, the estimate of coverage in children aged 24 months for 2023 is preliminary and will be revised with the coming year's survey estimate as more children in this birth cohort are added to the survey results. These data typically fluctuate from year to year and it is useful to look at 5-10 year trends to gain a clear understanding of how well children are being immunized in Utah.

How Do We Compare With the U.S.?

The Utah coverage rate for 4:3:1:3:3:1:4 immunization among 24-month-old children with the birth year 2021 was 74.9% while the United States coverage rate was 66.1%. Utah ranked 5th out of 50 states for this measure.

What Is Being Done?

The Utah Department of Health and Human Services Immunization Program conducts annual assessments of private and public health care providers' immunization records to obtain state immunization levels. During these site visits, Utah Immunization Program provider representatives also train clinic staff on appropriate vaccine storage, handling, and administration according to the Advisory Committee on Immunization Practices (ACIP) recommended practices. Utah also has immunization coalitions that are working to maintain or improve current levels of immunization and to increase public awareness of immunizations. The Utah Statewide Immunization Information System (USIIS) provides a mechanism for health care providers to track patient immunizations and send reminder cards to Utah parents whose children are due for immunizations. The USIIS also includes adult immunizations such as pneumonia, tetanus, and influenza. Due to the increased costs of vaccine, public health clinics are now able to provide publicly purchased vaccine only to those who meet eligibility criteria and don't have insurance coverage.