2008 Childhood Vaccination Rates Stable, Near Healthy People 2010 Goals

Childhood immunization rates in the United States are high and remained relatively stable last year, says a new report from the CDC, but a disparity exists between rates among children in families living below the poverty line and rates in children whose families are at or above that line.

"We continue to have an immunization gap for children in poor families," said Melinda Wharton, M.D., acting director of the CDC's National Center for Immunization and Respiratory Diseases, in an audio interview about the report posted Aug. 29 on the CDC's Web site. "There's about a 5 percent difference in series-complete coverage for children living below poverty compared to those at poverty or above."

During the interview, Wharton recapped findings from the CDC's 2008 National Immunization Survey, which were published in the Aug. 28 Morbidity and Mortality Weekly Report. The survey report estimated vaccination coverage among children 19 months to 35 months old at the time of the survey.

HHS' Healthy People 2010 initiative has set vaccination coverage goals of 90 percent for each vaccine in the 4:3:1:3:3:1 series and a goal of 80 percent for completion of the entire series, which consists of

In 2008, coverage for the entire series was 76.1, down slightly from the 2007 coverage estimate of 77.4 percent.

"It's not quite as high as we'd like," Wharton said. "Our national target is 80 percent, but it's stable and close to that at 76.1 percent, so I think we're doing a pretty good job. Of course, there's a little bit of room for improvement."

Coverage levels varied among states with the six-vaccine series, ranging from 59.2 percent in Montana to 82.3 percent in Massachusetts.

Five of the six individual vaccines in the series met the individual goal of 90 percent coverage. DTaP fell short, at 84.6 percent.

Coverage with the Hib vaccine decreased nearly 2 percent from the 2007 level but, at 90.9 percent, was still above the Healthy People 2010 goal. The CDC attributed the decrease to a shortage of the vaccine that began in December 2007 and that led to a temporary recommendation to defer the booster dose.

The agency said at least 8 percent of children in the survey likely were affected by that recommendation. The CDC -- in consultation with its Advisory Committee on Immunization Practices, or ACIP, the AAFP and the American Academy of Pediatrics -- recommended this past June that physicians reinstate the Hib booster dose as supplies started to return to normal levels.

"The good news is the shortage is over," Wharton said. "Children can get the full series again, and the children who missed that last dose can get it now."

The seven-valent pneumococcal conjugate vaccine, or PCV7, is not part of the 4:3:1:3:3:1 series, but it was included in the survey. Coverage with three or more doses of PCV7 increased from 90 percent the previous year to 92.8 percent, and coverage with four or more doses increased from 75.3 percent to 80.1 percent.

This was the first survey to include estimated coverage with two or more doses of hepatitis A vaccine, which was 40.4 percent. Coverage among newborns with the first dose of the hepatitis B vaccine was 55.3 percent, up from 53.2 percent in 2007.

"We're fortunate in the United States that because of high coverage we don't see these diseases very much, but many of them are only a plane ride away," Wharton said. "Many of these diseases are still common in other parts of the world, and people (returning to) the United States (from abroad) or visitors can bring them into the United States. Even people who don't travel can be exposed.

"Other diseases, like pertussis, still circulate in the United States, and we know that if vaccination rates drop, the diseases will come back, and there'll be outbreaks."

Wharton said families who can't afford vaccines can call (800) CDC-INFO to find out who to contact in their communities for help getting immunizations. She said they also can ask their physicians about the federal Vaccines for Children Program, which provides free vaccine to health care professionals for administration to certain Medicaid-eligible, uninsured or underinsured individuals.