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3 tables omitted
The implementation of state and local requirements for vaccination before
entry to Head Start programs, licensed child care facilities, and school has
resulted in high vaccination levels among preschool and school children.1,2 One of the national health objectives for 2010 is to maintain ≥95%
vaccination coverage among children attending licensed child care centers
and kindergarten through postsecondary school (objective 12-23).3 National
estimates of vaccination coverage among children in Head Start programs, licensed
child care facilities, and those entering school have been published each
year since 1997 on the basis of reports from federally funded immunization
programs (IPs) in the 50 states, five cities, eight territories, and the District
of Columbia.4 This report summarizes data reported by states, cities,
and the District of Columbia for the 2000-01 school year. Although vaccination
coverage for 2000-01 appears similar to that for previous years,4 the
number of programs reporting and the completeness of the reports are lower
than in previous years and do not permit precise estimation of coverage at
the national level. IPs use school data to identify undervaccinated children
enrolled in Head Start programs, licensed child care facilities, and those
entering school; evaluate the success of prevention programs targeting these
children; and document the proportion of children whose parents claim exemptions
from one or more vaccines. Plans are ongoing to assist IPs in applying successful
strategies for collecting, reporting, and increasing the precision of coverage
estimates for these populations.
Methods of assessing vaccination coverage differ among the 56 IPs, in
part because state and local laws determine which vaccines and doses are required
and because sampling and data abstraction methods vary. IPs used a standard
one-page form to report the proportion (2.9 to 100% for Head Start and child
care, 0.9 to 100% for kindergarten and first grade) of eligible children included
in the assessment and coverage for each required vaccine.
Of the 56 IPs, 23 states, New York City, and Chicago (44.6%) reported
vaccination coverage for children enrolled in Head Start programs. All 25
programs reported coverage for ≥3 doses of poliovirus vaccine; 17 (30.4%)
reported coverage for 3 doses of hepatitis B (HepB) vaccine; 16 (28.6%) reported
coverage for 4 doses of diphtheria and tetanus toxoids and pertussis (DTaP)
vaccine, 1 dose of measles, mumps, and rubella (MMR) vaccine, and 1 dose of Haemophilus influenzae type B (Hib) vaccine; and nine (16.1%)
reported coverage for 3 doses of DTaP and for ≥3 doses of Hib. Of all 108
estimates of vaccination coverage reported for the Head Start group, 86 (79.6%)
Of the 56 IPs, 23 states, New York City, and Chicago (44.6%) submitted
vaccination coverage levels for children enrolled in licensed child care.
All 25 programs reported coverage for ≥3 doses of poliovirus vaccine; 19
(33.9%) reported for 3 doses of HepB, 18 (32.1%) for 1 dose of MMR, 15 (26.8%)
for 4 doses of DTaP, 14 (25.0%) for 1 dose of Hib, 10 (17.9%) for ≥3 doses
of Hib, and nine (16.1%) for 3 doses of DTaP. Of all estimates of vaccination
coverage for the child care age group (n = 110), 60 (54.5%) were ≥95%.
Of the 56 IPs, 36 states and New York City (66.1%) submitted vaccination
coverage levels for children enrolled in kindergarten and/or first grade.
The number of programs reporting coverage varied by vaccine. All 37 programs
reported coverage for ≥3 doses of poliovirus vaccine, 27 (48.2%) programs
reported for 4 doses of DTaP and for 3 doses of HepB, 22 (39.3%) programs
for 2 doses of MMR, 10 (17.9%) programs for 3 doses of DTaP, and six (10.7%)
programs for 1 dose of MMR. Of all estimates of vaccination coverage reported
for the kindergarten/first grade age group (n = 129), 99 (76.7%) were ≥95%.
L Barker, Data Management Div; M McCauley, Office of the Director, National
Immunization Program; TL Fairley, PhD, EIS Officer, CDC.
Reported vaccination coverage for the 2000-01 school year for children
in Head Start programs, licensed child care facilities, and those entering
kindergarten and/or first grade appears similar to that reported in previous
years. However, the number of programs reporting and the completeness of the
reports are lower than in the past and do not permit coverage to be estimated
reliably at the national level. For the 1999-2000 school year, eight territories
were considered among the IPs. For the 2000-01 school year, no territories
reported, resulting in a smaller number of IPs. In addition, some IPs that
reported previously chose not to report for some facility types for the 2000-01
school year. These decreases in reporting and completeness from previous years
might be attributed to a diversion of resources to other vaccination activities
at both state and national levels.
The findings in this report are subject to at least three limitations.
First, approximately 40% of the states and cities did not submit 2000-01 vaccination
coverage estimates. Second, variation in sampling methodology among IPs might
limit the generalizability and comparability of these data.4 Finally,
children attending private schools were not surveyed by all of the programs.
Conducting regular assessments of vaccination coverage in group settings
such as child care facilities and school are key in monitoring the impact
of state requirements on vaccination coverage among U.S. children. These data
are the only measure of vaccination coverage available for this population
and the only data for measuring the 2010 national health objective. To assist
state and local IPs in collecting and reporting coverage data for children
in child care facilities and those entering school, CDC is developing a new
reporting system that will improve data quality and facilitate the reporting
process by automating many of the calculation/ data management tasks that
IPs have previously performed manually. This automated system will decrease
substantially the amount of personnel time devoted to producing annual reports.
In addition, CDC has instituted a reminder system to alert IPs when reports
are not submitted in a timely manner. These two approaches should facilitate
participation from all IPs.
References: 4 available
Vaccination Coverage Among Children Enrolled in Head Start Programs, Licensed Child Care Facilities, and Entering School—United States, 2000-01 School Year. JAMA. 2003;289(13):1629–1630. doi:10.1001/jama.289.13.1629
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