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


METHODS
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.


METHODS
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.
Zell
E R
ER
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga 30333.
Dietz
V
V
Stevenson
J
J
Cochi
S
S
Bruce
R H
RH
D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D004338:Drug Combinations; D006801:Humans; D007115:Immunization Schedule; D008458:Measles Vaccine / Q000008:administration & dosage; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine / Q000008:administration & dosage; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage; D011159:Population Surveillance; D012189:Retrospective Studies; D012411:Rubella Vaccine / Q000008:administration & dosage; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D014611:Vaccination / Q000592:standards / Q000706:statistics & numerical data*
D015721:Diphtheria-Tetanus-Pertussis Vaccine; D004338:Drug Combinations; D008458:Measles Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine; D011055:Poliovirus Vaccine, Oral; D012411:Rubella Vaccine