Low vaccination levels of US preschool and school-age children. Retrospective assessments of vaccination coverage, 1991-1992

E. R. Zell, V. Dietz, J. Stevenson, S. Cochi and R. H. Bruce
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga 30333.

OBJECTIVE--To obtain estimates on (1) the percentage of children who were up-to-date on the recommended childhood vaccination series, (2) the percentage of children who were age-appropriately immunized, and (3) coverage levels by individual vaccines. DESIGN--Vaccination levels were estimated by conducting retrospective immunization coverage surveys of the school health records of children entering kindergarten or first grade in the 1990-1991 or 1991-1992 school year. A multistage cluster survey design was used. SETTING--Survey sites were selected from among the 60 largest urban areas in the United States. One small city and one rural area were selected for comparison. RESULTS--By their second birthday, 11% to 58% (median, 44%) of the children were fully vaccinated. Stricter measurement criteria lowered coverage levels further. Completed series levels at school entry were 71% to 96% (median, 87%). CONCLUSIONS--Vaccination levels at the second birthday were far below the goal for the year 2000. All health providers need to administer vaccines according to the recommended schedule.

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