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2015-16 NHIS, BRFSS, and NIS-Flu Influenza Data

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The National Health Interview Survey (NHIS) is the data source used to monitor Healthy People 2020 objectives for influenza vaccination (IID-12.11-13). Influenza vaccination coverage estimates nationally and by state and selected local area from NIS-Flu and BRFSS are available each season approximately eleven months before final national estimates from NHIS. A comparison of national estimates from NIS-Flu and BRFSS to NHIS is available below for the 2015-16 season. Additional information on methods is available at Surveillance of Influenza Vaccination Coverage — United States, 2007–08 Through 2011–12 Influenza Seasons.

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Table 1. Influenza vaccination coverage* by age group and race/ethnicity, children 6 months through 17 years, National Health Interview Survey (NHIS) and National Immunization Survey-Flu (NIS-Flu), United States, 2015-16 influenza season

Total Change from
2014-15|| to 2015-16
influenza
season
(percentage
points)
White only,
non-Hispanic
Black only,
non-Hispanic
Hispanic Other,
non-Hispanic
Surveillance System Unweighted
Sample Size
%§ 95% CI   % 95% CI % 95% CI % 95% CI % 95% CI
NHIS
Age group
6 months-17 years 7,325 51.8 ±2.0 -1.3 47.7 ±2.5 52.6 ±5.3 55.2 ±4.5 62.8 ±5.1
6-23 months 696 67.4 ±6.7 1.0 65.5 ±7.8 80.6 ±17.2 62.4 ±13.1 67.2 ±17.6
2-4 years 1,214 61.8 ±4.7 4.0 56.4 ±6.5 73.1 ±18.6 67.1 ±10.6 65.0 ±13.1
5-12 years 3,187 50.1 ±2.5 -5.3 46.3 ±3.5 45.6 ±6.5 53.9 ±5.9 65.2 ±7.1
13-17 years 2,228 43.0 ±3.5 1.2 39.7 ±4.5 44.1 ±10.0 46.4 ±8.4 51.6 ±10.4
NIS-Flu
Age group
6 months-17 years 126,846 59.3 ±0.8 0.0 55.3  ±0.9 60.9 ±2.1 64.7 ±2.0 64.8 ±2.4
6-23 months 14,827 75.3 ±1.7 0.7 74.1 ±2.2 74.2 ±4.9 75.6 ±4.2 80.9 ±4.3
2-4 years 23,886 66.8 ±1.8 -1.0 63.2 ±2.2 65.2 ±5.6 72.3 ±4.4 72.7 ±4.8
5-12 years 54,825 61.8 ±1.2 0.0 58.1 ±1.3 63.3 ±2.9 66.7 ±3.0 65.8 ±3.8
13-17 years 33,308 46.8 ±1.4 0.2 42.9 ±1.6 50.3 ±4.1 52.6 ±3.5 51.6 ±4.1
Difference percent vaccinated, NIS-Flu – NHIS
Age group
6 months-17 years 7.5 ±2.2 7.6 ±2.7 8.3 ±5.7 9.5 ±4.9 2.0 ±5.6
6-23 months 7.9 ±6.9 8.6 ±8.1 -6.4 ±17.9 13.2 ±13.8 13.7 ±18.1
2-4 years 5.0 ±5.0 6.8 ±6.9 -7.9 ±19.4 5.2 ±11.5 7.7 ±14.0
5-12 years 11.7 ±2.8 11.8 ±3.7 17.7 ±7.1 12.8 ±6.6 0.6 ±8.1
13-17 years 3.8 ±3.8 3.2 ±4.8 6.2 ±10.8 6.2 ±9.1 0.0 ±11.2

Abbreviation: CI = Confidence Interval

* Estimates of the percentage of people vaccinated are based on interviews conducted beginning September (NHIS) or October (NIS-Flu) 2015 through June 2016 and reported vaccinations from July 2015 through May 2016.

Race/ethnicity is based on parental report. Persons categorized as white, black, or other were identified as non-Hispanic. Persons identified as Hispanic might be of any race. The other race category includes Asian, American Indian/Alaska Native (AI/AN), and multiple races.

Excludes U.S. territories.

§ Percentage vaccinated. Percentages are weighted to the non-institutionalized, U.S. civilian population. Month of vaccination was imputed for respondents with missing month of vaccination data (n= 585 [11.5%] in NHIS, n= 13,767 [18.2%] in NIS-Flu).

|| Estimates of the percentage of people vaccinated based on interviews conducted September (NHIS) or October (NIS-Flu) 2014 through June 2015 and reported vaccinations from July 2014 through May 2015.

Statistically significant difference between the 2015-16 NIS-Flu and the 2015-16 NHIS season by t-test (p<0.05).

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Table 2. Influenza vaccination coverage* by age group, high-risk status, and race/ethnicity, adults 18 years and older, Behavioral Risk Factor Surveillance System (BRFSS) and National Health Interview Survey (NHIS) United States,§ 2015-16 influenza season

Total Change from
2014-15
to 2015-16
influenza
season
(percentage
points)
White only,
non-Hispanic
Black only,
non-Hispanic
Hispanic Other,
non-Hispanic
Surveillance System Unweighted
Sample Size
%|| 95% CI   % 95% CI % 95% CI % 95% CI % 95% CI
NHIS
Age group
≥18 years 26,219 43.6 ±1.2 -1.0 46.2 ±1.2 40.5 ±3.5 33.5 ±3.1 46.5 ±4.1
18-64 years 19,293 36.9 ±1.2 -0.8 38.2 ±1.4 36.1 ±3.7 30.5 ±3.3 42.2 ±4.5
18-64 years with high-risk conditions 3,937 48.2 ±2.5 2.2 47.9 ±2.9 50.5 ±7.6 47.2 ±7.6 49.0 ±10.6
18-64 years without high-risk conditions 15,319 34.2 ±1.4 -1.6 35.7 ±1.6 32.4 ±4.1 27.4 ±3.7 40.3 ±4.5
18-49 years 12,497 32.3 ±1.6 -0.3 33.0 ±1.8 32.0 ±4.5 28.0 ±3.9 37.0 ±4.7
18-49 years with high-risk conditions 1,729 37.1 ±3.7 1.3 37.6 ±4.3 40.1 ±10.4 35.8 ±11.8 33.8 ±11.4
18-49 years without high-risk conditions 10,750 31.5 ±1.6 -0.6 32.3 ±2.0 30.9 ±4.9 27.1 ±4.1 37.1 ±4.9
50-64 years 6,796 46.8 ±2.0 -1.9 47.1 ±2.2 45.5 ±6.1 40.0 ±6.1 55.7 ±8.6
≥65 years 6,926 70.6 ±1.8 -2.9 72.2 ±2.0 65.2 ±5.7 59.4 ±8.0 73.6 ±7.3
BRFSS
Age group
≥18 years 319,167 41.7 ±0.4 -1.9 44.5 ±0.6 36.6 ±1.6 34.4 ±1.8 41.0 ±2.4
18-64 years 205,848 36.3 ±0.6 -1.7 37.9 ±0.6 33.3 ±1.6 31.9 ±2.0 39.0 ±2.4
18-64 years with high-risk conditions 53,798 46.0 ±1.2 -1.6 47.4 ±1.2 42.3 ±3.1 42.3 ±4.3 48.2 ±6.3
18-64 years without high-risk conditions 149,939 33.5 ±0.6 -1.8 35.1 ±0.6 29.9 ±2.0 29.7 ±2.2 36.0 ±2.4
18-49 years 105,988 32.7 ±0.8 -0.8 33.6 ±0.8 30.4 ±2.2 29.9 ±2.2 37.1 ±2.9
18-49 years with high-risk conditions 18,662 39.5 ±2.0 0.2 40.0 ±2.2 37.1 ±4.9 37.6 ±5.9 42.7 ±9.4
18-49 years without high-risk conditions 86,111 31.5 ±0.8 -1.1 32.5 ±0.8 28.7 ±2.4 28.8 ±2.4 35.5 ±2.7
50-64 years 99,860 43.6 ±0.8 -3.4 44.8 ±0.8 39.4 ±2.5 40.7 ±4.3 45.8 ±3.9
≥65 years 113,319 63.4 ±0.8 -3.3 64.6 ±0.8 54.3 ±3.1 62.9 ±4.7 59.1 ±5.7
Difference in percent vaccinated, BRFSS-NHIS
Age group
≥18 years -1.9** ±1.3 -1.7** ±1.3 -3.9** ±3.8 0.9 ±3.6 -5.5** ±4.8
18-64 years -0.6 ±1.3 -0.3 ±1.5 -2.8 ±4.0 1.4 ±3.9 -3.2 ±5.1
18-64 years with high-risk conditions -2.2 ±2.8 -0.5 ±3.1 -8.2 ±8.2 -4.9 ±8.7 -0.8 ±11.8
18-64 years without high-risk conditions -0.7 ±1.5 -0.6 ±1.7 -2.5 ±4.6 2.3 ±4.3 -4.3 ±5.1
18-49 years 0.4 ±1.8 0.6 ±2.0 -1.6 ±5.0 1.9 ±4.5 0.1 ±5.5
18-49 years with high-risk conditions 2.4 ±4.2 2.4 ±4.8 -3.0 ±11.1 1.8 ±12.5 8.9 ±14.8
18-49 years without high-risk conditions 0.0 ±1.8 0.2 ±2.2 -2.2 ±5.5 1.7 ±4.8 -1.6 ±5.6
50-64 years -3.2** ±2.2 -2.3 ±2.3 -6.1 ±6.6 0.7 ±7.5 -9.9** ±9.4
≥65 years -7.2** ±2.0 -7.6** ±2.2 -10.9** ±6.5 3.5 ±9.3 -14.5** ±9.3

Abbreviation: CI = Confidence Interval

* Estimates of the percentage of people vaccinated are based on interviews conducted beginning September 2015 through June 2016 and reported vaccinations from July 2015 through May 2016.

High-risk definition based on the NHIS: adults categorized as at high risk for influenza-related complications self-reported one or more of the following: (1) ever being told by a physician they had diabetes, emphysema, chronic obstructive pulmonary disease, coronary heart disease, angina, heart attack, or other heart condition; (2) having a diagnosis of cancer during the preceding 12 months (excluding nonmelanoma skin cancer) or ever being told by a physician they have lymphoma, leukemia, or blood cancer during the previous 12 months; (3) being told by a physician they have chronic bronchitis or weak or failing kidneys; or (4) reporting an asthma episode or attack during the preceding 12 months. High-risk definition based on the BRFSS:  adults categorized as at high risk for influenza-related complications self-reported diabetes, asthma, myocardial infarction, coronary heart disease, chronic obstructive pulmonary disease (COPD), or cancer (excluding skin cancer). Because data on high risk status may be missing for some adults in both NHIS and BRFSS, the sample sizes for the high risk categories for the various age groups may not add up to the total sample size for that age group.

Race/ethnicity is based on self report. Persons categorized as white, black, or other were identified as non-Hispanic. Persons identified as Hispanic might be of any race. The other race category includes Asian, American Indian/Alaska Native (AI/AN), and multiple races.

§ Excludes U.S. territories.

|| Percentage vaccinated. Percentages are weighted to the non-institutionalized, U.S. population. Month of vaccination was imputed for respondents with missing month of vaccination data (n= 550 [3.8%] in NHIS, n= 9,995 [6.7%] in BRFSS).

Estimates of the percentage of people vaccinated based on interviews conducted September 2014 through June 2015 and reported vaccinations from July 2014 through May 2015.

** Statistically significant difference between the 2015-16 BRFSS and the 2015-16 NHIS season by t-test (p<0.05).

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