2012-13 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 2012-13 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,† 2012-13 influenza season

Total Change
from 2011-12||
to 2012-13
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

8,658

 50.5 ± 1.8

3.4

 47.8 ± 2.5 49.6 ± 4.5 53.6 ± 2.9 58.7 ± 5.3
      6-23 months

811

 69.2 ± 5.9

1.2

 64.3 ± 8.2 88.1 ± 14.9 67.7 ± 10.0 79.7 ± 13.9
      2-4 years

1,547

 60.1 ± 4.3

-0.3

 58.5 ± 6.1 53.9 ± 14.3 60.5 ± 7.4 73.8 ± 15.3
      5-12 years

3,707

 49.2 ± 2.4

2.4

 46.2 ± 3.3 50.0 ± 7.3 52.9 ± 4.1 56.1 ± 7.1
      13-17 years

2,593

 40.8 ± 3.3

6.0

 39.4 ± 4.9 35.3 ± 7.6 44.3 ± 5.5 47.2 ± 10.4
NIS-Flu
   Age Group
      6 months-17 years

100,829

 56.6 ± 0.9

5.1

 53.8 ± 1.0 56.7 ± 2.7 60.9 ± 2.2 60.8 ± 2.7
      6-23 months

10,632

 76.9 ± 2.3

2.3

 75.5 ± 2.5 75.8 ± 7.9 79.8 ± 5.3 77.4 ± 5.6
      2-4 years

18,082

 65.8 ± 2.0

2.5

 63.9 ± 2.4 63.3 ± 5.9 69.3 ± 4.5 68.6 ± 5.6
      5-12 years

47,526

 58.6 ± 1.3

4.4

 55.9 ± 1.4 58.4 ± 3.8 62.1 ± 3.2 64.5 ± 3.7
      13-17 years

24,589

 42.5 ± 1.5

8.8

 41.4 ± 1.7 44.1 ± 4.5 45.1 ± 4.1 42.1 ± 4.5
Difference Percent Vaccinated, NIS-Flu -NHIS
   Age Group
      6 months-17 years 6.1** ± 2.0 6.0** ± 2.2 7.1** ± 5.2 7.3** ± 3.6 2.1 ± 5.9
      6-23 months 7.7** ± 6.3 11.2** ± 8.6 -12.3 ± 16.1 12.1** ± 11.3 -2.3 ± 14.2
      2-4 years 5.7** ± 4.7 5.4 ± 6.6 9.4 ± 15.2 8.8** ± 8.7 -5.2 ± 16.0
      5-12 years 9.4** ± 2.7 9.7** ± 3.6 8.4** ± 8.2 9.2** ± 5.2 8.4** ± 8.0
      13-17 years 1.7 ± 3.6 2.0 ± 5.2 8.8 ± 8.8 0.8 ± 6.9 -5.1 ± 11.0

* Estimates of the percentage of people vaccinated are based on interviews conducted beginning September (NHIS) or October (NIS-Flu) 2012 through June 2013 and reported vaccinations from July 2012 through May 2013.

† 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.

§ Confidence interval half-widths.

|| Estimates of the percentage of people vaccinated based on interviews conducted September (NHIS) or October (NIS-Flu) 2011 through June 2012 and reported vaccinations from August 2011 through May 2012.

Includes Asian, American Indian/Alaska Native (AI/AN), and multiple races.

** Statistically significant difference between the 2012-13 NIS-Flu and the 2012-13 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,‡ 2012-13 season
Total Change
from 2011-12
to 2012-13
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

27,717

 42.6 ± 1.0

3.4

 46.5 ± 1.4 33.5 ± 2.7 30.6 ± 2.2 46.8 ± 3.1
      18-64 years

21,609

 36.1 ± 1.2

3.5

 38.9 ± 1.6 29.5 ± 2.9 27.1 ± 2.2 43.0 ± 3.5
      18-64 years with high-risk conditions

4,306

 49.5 ± 2.4

4.8

 49.0 ± 2.9 45.8 ± 6.7 49.4 ± 5.9 63.5 ± 9.2
      18-64 years without high-risk conditions

17,265

 32.9 ± 1.2

3.9

 36.2 ± 1.6 25.5 ± 2.7 23.2 ± 2.4 39.3 ± 3.9
      18-49 years

14,575

 30.5 ± 1.4

3.4

 32.2 ± 2.0 26.4 ± 3.1 24.1 ± 2.5 40.1 ± 4.1
      18-49 years with high-risk conditions

2,016

 39.0 ± 3.3

3.1

 36.6 ± 3.9 40.5 ± 8.6 39.7 ± 8.2 58.7 ± 13.9
      18-49 years without high-risk conditions

12,541

 29.3 ± 1.4

4.2

 31.4 ± 2.0 24.3 ± 3.3 22.3 ± 2.5 38.1 ± 4.5
      50-64 years

7,034

 48.0 ± 2.0

3.3

 50.7 ± 2.4 36.9 ± 4.9 39.2 ± 5.1 51.7 ± 7.1
      ≥65 years

6,108

 71.6 ± 2.0

1.5

 73.6 ± 2.4 59.2 ± 5.7 64.3 ± 6.5 72.5 ± 9.4
BRFSS
   Age Group
      ≥18 years

348,686

 41.5 ± 0.4

2.7

 44.6 ± 0.4 35.6 ± 1.6 33.8 ± 1.8 41.6 ± 2.2
      18-64 years

232,856

 35.7 ± 0.6

2.6

 37.5 ± 0.6 32.6 ± 1.8 31.4 ± 1.8 38.7 ± 2.4
      18-64 years with high-risk conditions

61,072

 45.4 ± 1.2

1.6

 46.2 ± 1.2 43.5 ± 3.5 45.0 ± 4.3 46.4 ± 4.5
      18-64 years without high-risk conditions

169,331

 32.9 ± 0.6

2.5

 34.9 ± 0.6 28.6 ± 2.0 28.2 ± 2.0 37.0 ± 2.7
      18-49 years

120,286

 31.1 ± 0.8

2.5

 32.1 ± 0.8 29.3 ± 2.2 28.8 ± 2.2 35.7 ± 2.7
      18-49 years with high-risk conditions

21,768

 38.1 ± 1.8

2.4

 37.7 ± 2.0 37.5 ± 5.5 40.3 ± 5.3 40.6 ± 6.5
      18-49 years without high-risk conditions

97,149

 29.8 ± 0.8

2.0

 31.1 ± 0.8 27.3 ± 2.4 26.7 ± 2.4 35.2 ± 3.1
      50-64 years

112,570

 45.1 ± 0.8

2.4

 46.2 ± 0.8 40.3 ± 2.5 42.5 ± 3.5 48.9 ± 3.9
      ≥65 years

115,830

 66.2 ± 0.8

1.3

 67.9 ± 0.8 54.5 ± 3.3 65.8 ± 5.3 64.4 ± 4.7
Difference in percent vaccinated, BRFSS – NHIS
   Age Group
      ≥18 years -1.1†† ± 1.1 -1.9†† ± 1.5 2.1 ± 3.1 3.2†† ± 2.8 -5.2†† ± 3.8
      18-64 years -0.4 ± 1.3 -1.4 ± 1.7 3.1 ± 3.4 4.3†† ± 2.8 -4.3†† ± 4.2
      18-64 years with high-risk conditions -4.1†† ± 2.7 -2.8 ± 3.1 -2.3 ± 7.6 -4.4 ± 7.3 -17.1†† ± 10.2
      18-64 years without high-risk conditions 0.0 ± 1.3 -1.3 ± 1.6 3.1 ± 3.4 5.0†† ± 3.1 -2.3 ± 4.7
      18-49 years 0.6 ± 1.6 -0.1 ± 2.2 2.9 ± 3.1 4.7†† ± 3.3 -4.4 ± 4.9
      18-49 years with high-risk conditions -0.9 ± 3.8 1.1 ± 3.6 -3.0 ± 10.2 0.6 ± 9.8 -18.1†† ± 14.5
      18-49 years without high-risk conditions 0.5 ± 1.6 -0.3 ± 2.2 3.0 ± 4.1 4.4†† ± 3.5 -2.9 ± 5.5
      50-64 years -2.9†† ± 2.2 -4.5†† ± 2.5 3.4 ± 4.9 3.3 ± 5.1 -2.8 ± 7.2
      ≥65 years -5.4†† ± 2.2 -5.7†† ± 2.5 -4.7 ± 5.7 1.5 ± 6.5 -8.1 ± 9.4

* Estimates of the percentage of people vaccinated are based on interviews conducted beginning September 2012 through June 2013 and reported vaccinations from July 2012 through May 2013.

† High-risk definition based on the NHIS: adults categorized as at high risk for influenza-related complications self-reported 1 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 includes adults with diabetes, asthma, myocardial infarction, coronary heart disease, chronic obstructive pulmonary disease (COPD), or cancer (excluding skin cancer).

‡ 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.

|| Confidence interval half-widths.

Estimates of the percentage of people vaccinated based on interviews conducted September 2011 through June 2012 and reported vaccinations from August 2011 through May 2012.

** Includes Asian, American Indian/Alaska Native (AI/AN), and multiple races.

†† Statistically significant difference between the 2012-13 BRFSS and the 2012-13 NHIS season by t-test (P<0.05).

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