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Explore the progress in immunization and infectious diseases through vaccines, prevention, and impact on public health. Highlights objectives, vaccine coverage data, and targets.
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Healthy People 2010 Focus Area 14:Immunization & Infectious Diseases Progress ReviewJuly 20, 2007
Immunization • Vaccines are currently available to protect against 16 diseases • Morbidity for vaccine-preventable diseases has been reduced • 99+ percent reduction since the introduction of vaccines • 7 vaccines (DTaP, Td, Hib, polio, MMR, hepatitis B, and varicella) • prevent 14+ million cases of disease • prevent 33,500+ deaths over the lifetime of children born each year • prevent the need to take time off from work, seek care for, and tend to the needs of sick patients • annual savings exceed $40 billion
Infectious Diseases • Pneumonia/ influenza is the 8th leading cause of death in the U.S. • 18% of all physician visits each year are for infectious diseases • Antimicrobial agents are the 5th most frequently prescribed class of drugs • Treatment and lost productivity associated with infectious agents exceeds $120 billion each year
Highlighted Objectives Immunization objectives 14-22 a-h. Universally recommended vaccinations Infectious disease objectives 14-5 a-d. Invasive pneumococcal infections 14-8. Lyme disease Hepatitis objectives 14-3 a-g. Hepatitis B in adults Tuberculosis (TB) objectives 14-11. New cases of TB Antibiotics objectives 14-18. Antibiotics prescribed for ear infections 14-19. Antibiotics prescribed for common cold Target met Improving Little or no change* Getting worse Baseline only Note: *Percent of targeted change achieved is between -10% and 10%.
Impact of Pre-1990 Vaccines Percent Decrease * ** Note: * Type b and unknown (< 5 years of age). ** Imported vaccine-associated paralytic polio (VAPP). Numbers in blue indicate at or near record lows in 2005. Source: Pre-Vaccine Licensure data - CDC. MMWR. April 2, 1999 / 48: 242-264; 2005 data - CDC. MMWR. August 18, 2006 / 55(32): 880-893.
Impact of Recent Vaccines Source: CDC, unpublished data, Nov 2006.
Vaccine-Specific Coverage: Preschool-Aged Children Increase desired Percent 2010 Target: 90 100 80 DTP(3+)† Hep B (3+) PCV 7 (3+) 60 MMR(1+) Polio (3+) 40 Hib (3+) 20 Varicella (1+) 0 2005 1967 1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000 2003 Note: † DTP(3+) is not a Healthy People 2010 objective. DTP(4) is used to assess Healthy People 2010 objective 14-22a. Children in the USIS and NHIS were 24-35 months of age. Children in the NIS were 19-35 months of age. No data from 1986-1990 due to cancellation of USIS because of budget reductions. Source: USIS (1967-1985), NHIS (1991-1993) CDC, NCHS, and NIS (1994-2005), CDC, NCIRD and NCHS; Obj. 14-22b-g
4:3:1:3:3:1 Vaccination Coverage: Children 19-35 Months Percent 90 80 White Black 70 Hispanic 60 0 2002 2003 2004 2005 Note: 4+ doses of DTP, 3+ doses of poliovirus vaccine, 1+ doses of any MMR, 3+ doses of Hib, 3+ doses of HepB, and 1+ doses of varicella. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: National, State and Urban Area Vaccination Coverage Among Children Aged 19-35 Months, United States, 2005. MMWR Morb Mortal Wkly Rep 2006;55:36;988-993 Obj. 14-24a (mod.)
4:3:1:3:3:1* Series Coverage: Children 19-35 Months, 2005 National Coverage = 76% 90% 80-89% 70-79% 69% Note: *4+DTP, 3+Polio, 1+MMR, 3+Hib, 3+HepB, 1+ varicalla. Source: National Immunization Survey (NIS), CDC, NCIRD and NCHS. Obj. 14-24a (mod.)
Invasive Pneumococcal Infections Decrease desired New cases per 100,000 population 100 Children (<5 years) 80 60 Older adults (>65 years) Children 2010 Target: 46 40 Older adults 2010 Target: 42 20 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 Source: Active Bacterial Core Surveillance (ABCs), CDC, NCIRD, Emerging Infections Program Network. Obj. 14-5
Invasive Pneumococcal Infections, 2005 Decrease desired 2010 Target: 46 2010 Target: 42 Black White New cases per 100,000 population Children (<5 years) Older adults (>65 years) Source: Active Bacterial Core Surveillance (ABCs), CDC, NCIRD, Emerging Infections Program Network. Obj. 14-5
Lyme Disease: Endemic* States Decrease desired 2010 Target: 9.7 Average annual new cases per 100,000 population 50 40 30 20 10 0 1996 1999 2000 2001 2002 2003 2004 2005 Note: *10 reference states where the disease is endemic (Connecticut, Delaware, Maryland, Massachusetts, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island, and Wisconsin). Each data point represents a 5-year average (i.e. ‘1996’ data are from 1992-1996). Source: National Notifiable Diseases Surveillance System (NNDSS), CDC, NCPHI. Obj. 14-8
Hepatitis B Decrease desired 2010 Target 5.2 3.7 1.8 New cases per 100,000 population 25 20 25-39 years 15 19-24 years 40+ years 10 5 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 Source: National Notifiable Diseases Surveillance System (NNDSS), CDC, NCPHI. Obj. 14-3
Hepatitis B, 2005 Decrease desired 2010 Target: 5.2 2010 Target: 3.7 2010 Target: 1.8 American Indian Hispanic Asian White Black New cases per 100,000 population 19-24 years 25-39 years 40+ years Note: American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. Source: National Notifiable Diseases Surveillance System (NNDSS), CDC, NCPHI. Obj. 14-3
Tuberculosis Decrease desired 30 20 Total 0 1982 2005 2010 Target 1.0 New cases per 100,000 population 50 Asian 40 30 Hispanic 20 Black American Indian 10 White 0 1993 1995 1997 1999 2001 2003 2005 *All races are non-Hispanic. In 2003, Asian/Pacific Islander category includes persons who reported race as Asian only and/or Native Hawaiian or Other Pacific Islander only.**Updated as of March 29, 2006. Note: American Indian includes Alaska Native. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: National TB Surveillance System, CDC, NCHHSTP. Obj. 14-11
Antibiotics Prescribed for Ear Infections: Children Under 5 Years Decrease desired 2010 Target: 56 Courses per 100 population 1996-97 2004-05 Source: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS; National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS. Obj. 14-18
Antibiotics Prescribed for Common Cold Decrease desired 2010 Target: 1.268 Courses per 100 population 1996-97 2004-05 * Note: *Data are unreliable. Source: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS; National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS. Obj. 14-19
Immunization & Infectious Diseases Objective Status Target met or exceeded Improving Little or no change* Getting worse No trend data Dropped at midcourse Retained as developmental 31 34 4 7 6 1 3 Note: *Percent of targeted change achieved is between -10% and 10%.
Summary • Substantial progress – most objectives met or moving toward 2010 targets • Racial disparities persist, although there is evidence of improvement • Challenges – Lyme disease, Pertussis
Progress review data and slides are available on the web at: http://www.cdc.gov/nchs/hphome.htm