title: Uptake of pneumococcal conjugate vaccine among children in the 1998-2002 United States birth cohorts.
abstract: BACKGROUND
  Routine childhood immunization with pneumococcal conjugate vaccines (PCV7s) began in 2000 in the United States. Despite vaccine shortages, reductions in invasive pneumococcal disease occurred rapidly during 2000-2002. Age-appropriate PCV7 coverage was estimated and characteristics associated with undervaccination were identified for children in the 1998-2002 birth cohorts.
  
  
  METHODS
  Data were analyzed for 85,135 children aged 19-35 months in the 2001-2004 National Immunization Surveys. To obtain PCV7 coverage estimates by birth cohorts, a pooled analysis was conducted by combining individual survey years that sampled children with appropriate birth dates. Logistic regression models were used to identify factors associated with age-appropriate vaccination.
  
  
  RESULTS
  The proportion of children receiving the primary 3-dose PCV7 series by age 12 months increased from 45.5% (+/-0.6) among children born in 2000 to 62.1% (+/-0.7) among those born in 2002. By age 24 months, an estimated 30.7% (+/-0.6), 38.0% (+/-0.6), and 49.0% (+/-1.1) of children born in 2000, 2001 and 2002, respectively, had received all four PCV7 doses; however, only 15.0% (+/-0.4), 16.1% (+/-0.4) and 24.4% (+/-0.6) of children were age-appropriately immunized. Among children born in 1998 and 1999, 10.1% +/-0.5) and 37.6% (+/-0.7), respectively, received one or more catch-up doses during their second year of life. Lower age-appropriate PCV7 coverage was independently associated with black race, Hispanic ethnicity, receiving vaccinations from public health providers, and low household income.
  
  
  CONCLUSIONS
  The dramatic reductions in pneumococcal-related diseases from direct and indirect vaccine effects occurred when few children had received the recommended complete vaccine schedule, and there were substantial racial and socioeconomic disparities in coverage.
authors: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. pnuorti@cdc.gov
authors: J Pekka
authors: JP
authors: Nuorti
authors: Stacey W
authors: SW
authors: Martin
authors: Philip J
authors: PJ
authors: Smith
authors: John S
authors: JS
authors: Moran
authors: Benjamin
authors: B
authors: Schwartz
mesh_terms: D002675:Child, Preschool; D004363:Drug Utilization; D005191:Family Characteristics; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D008297:Male; D022401:Meningococcal Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution; D012959:Socioeconomic Factors; D014481:United States; D018074:Vaccines, Conjugate
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate