National Progress Report 2020 Goal: Increase the percentage of children aged 19–35 months who receive ≥2 doses of hepatitis A vaccine to 85.0%
Percentage of children aged 19–35 months* who received ≥2 doses of hepatitis A vaccine
Source: CDC, National Immunization Survey-Child (1–2)
*For 2010, children born 1/2007–5/2009; for 2011, children born 1/2008–5/2010; for 2012, children born 1/2009–5/2011; for 2013, children born 1/2010–5/2012; for 2014, children born 1/2011–5/2013; for 2015, children born 1/2012–5/2014; for 2016, children born 1/2013–5/2015; and for 2017, children born 1/2014-5/2016.
Summary of Findings
No progress was made between 2016 and 2017 in increasing the percentage of children aged 19–35 months receiving ≥2 doses of hepatitis A vaccine; therefore, the 2017 target of 71.3% was not met. Although single-dose vaccination rates are relatively high among children, multiple doses are needed for full coverage.
Increase needed to meet 2020 goal: A 40.9% increase from the vaccination percentage reported in 2017 is needed to meet the 2020 goal of 85%.
This increase can best be achieved by
- Identifying and removing barriers to hepatitis A vaccination among children by implementing evidence-based strategies to increase vaccination as recommended by the Community Preventive Services Task Forceexternal icon.
- Ensuring that providers continue to follow existing immunization schedules and Advisory Committee on Immunization Practices (ACIP) Vaccine Recommendations and Guidelines.
- Implementing state school immunization requirementspdf icon.
Data Source: CDC, National Immunization Survey-Child (NIS-Child)
Numerator: Number of children aged 19–35 months who had received ≥2 doses of hepatitis A vaccine
Denominator: Number of children aged 19–35 months
Indicator Notes: (1-3) The NIS-Child monitors vaccination coverage among children aged 19–35 months in the 50 states, the District of Columbia, selected local areas, and U.S. territories using a random-digit dialing sample of landline and cellular telephone numbers. After identifying a household with at least one age-eligible child, a telephone interview is conducted to collect sociodemographic characteristics for all age-eligible children and to request permission to contact the child’s vaccination providers. If consent is given, a survey is mailed to each provider to request the child’s vaccination history, including dates of receipt of vaccine doses. Data are weighted to represent the population of children aged 19–35 months, with adjustments for households with multiple telephone lines and mixed telephone use (landline and cellular), household nonresponse, and exclusion of households without telephone service. Beginning in 2011, surveys include landline and cellular telephone households. NIS-Child data for 2010 include children born January 2007 through May 2009; for 2011, children born January 2008 through May 2010; for 2012, children born January 2009 through May 2011; for 2013, children born January 2010 through May 2012; for 2014, children born January 2011 through May 2013; for 2015, children born January 2012 through May 2014; for 2016, children born January 2013 through May 2015; and for 2017, children born January 2014 through May 2016.
Goal Setting: The 2020 goal of 85% is consistent with the Healthy People 2020 Objectiveexternal icon (IID-7.8) and other national programs, regulations, policies, and laws. Annual targets assume a constant (linear) rate of change from the observed baseline (2014) to the 2020 goal.
Limitations: Low response rates, incomplete sampling frames, and potential misclassification of vaccination status in the NIS-Child may lead to bias in estimating vaccination coverage. NIS-Child estimates of the number of children receiving ≥2 hepatitis A doses likely underestimate the proportion of children who ultimately complete the vaccination series. The NIS-Child does not assess coverage for children aged >35 months, yet the recommended vaccination schedule for children is a dose of hepatitis A vaccine at age 12–23 months, with a second dose administered 6–18 months later. Therefore, children receiving the second dose of hepatitis A vaccine on schedule between 36 and 41 months of age would not be captured through NIS-Child.
- Hill HA, Elam-Evans LD, Yankey D, Singleton JA, Kang Y. Vaccination coverage among children aged 19-35 months – United States, 2017. MMWR Morbidity and Mortality Weekly Report. 2018; 67(40):1123-1128.
- Hill HA, Elam-Evans LD, Yankey D, Singleton JA, Kolasa M. National, state, and local area vaccination coverage among children aged 19-35 months – United States, 2014. MMWR Morbidity and Mortality Weekly Report. 2015; 64(33):889-896.
- Centers for Disease Control and Prevention. Datasets and Related Documentation for the National Immunization Survey. http://www.cdc.gov/nchs/nis/data_files.htm. Accessed April 5, 2017.