Skip Navigation LinksSkip Navigation Links
Centers for Disease Control and Prevention
Safer Healthier People
Blue White
Blue White
bottom curve
CDC Home Search Health Topics A-Z spacer spacer
spacer
Blue curve MMWR spacer
spacer
spacer

Status Report on the Childhood Immunization Initiative: National, State, and Urban Area Vaccination Coverage Levels Among Children Aged 19-35 Months -- United States, 1996

The 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 Coverage with three or more doses of hepatitis B vaccine increased from 8% (CDC, unpublished data) in 1992 to 82% in 1996 (Table_1).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 Note

Editorial 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

  1. CDC. Reported vaccine-preventable diseases -- United States, 1993, and the Childhood Immunization Initiative. MMWR 1994;43:57-60.

  2. CDC. Status report on the Childhood Immunization Initiative: reported cases of selected vaccine-preventable diseases -- United States, 1996. MMWR 1997;46:665-71.

  3. CDC. State and national vaccination coverage levels among children aged 19-35 months -- United States, April-December 1994. MMWR 1995;44:613,619-23.

  4. CDC. National, state, and urban area vaccination coverage levels among children aged 19-35 months -- United States, January-December 1995. MMWR 1997;46:176-82.

  5. CDC. Sample design and procedures to produce estimates of vaccination coverage in the National Immunization Survey. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, CDC, National Immunization Program, April 18, 1996.

  6. CDC. Vaccination coverage of 2-year-old children -- United States, 1993. MMWR 1994;43:705-9.

  7. CDC. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1996;45(no. RR-11).

  8. Cordero JF, Orenstein WA. The future of immunization registries. Am J Prev Med 1997; 13(suppl):S122-S124.

  9. LeBaron CW, Chaney M, Baughman AL, et al. Impact of measurement and feedback on vaccination coverage in public clinics, 1988-1994. JAMA 1997;277:631-5.

* 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.                       
=============================================================================================================                                        

Return to top.

Disclaimer   All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

Page converted: 09/19/98

HOME  |  ABOUT MMWR  |  MMWR SEARCH  |  DOWNLOADS  |  RSSCONTACT
POLICY  |  DISCLAIMER  |  ACCESSIBILITY

Safer, Healthier People

Morbidity and Mortality Weekly Report
Centers for Disease Control and Prevention
1600 Clifton Rd, MailStop E-90, Atlanta, GA 30333, U.S.A

USA.GovDHHS

Department of Health
and Human Services

This page last reviewed 5/2/01