2005 National Immunization Survey

1. 2005National Immunization Survey Stephen L. Cochi, M.D., M.P.H. Acting Director National Immunization Program, CDC National Press Club July 27, 2005 Department of Health and Human Services Centers for Disease Control and Prevention

2. Vaccines are one of the most important tools we have to protect the health of our nation's most vulnerable citizens, our children.

3. Vaccines areHighly Cost Effective • DTaP saves. . . . . . . . . . . . . . . . $27.00 • MMR saves . . . . . . . . . . . . . . . . $26.00 • Perinatal Hep B saves . . . . . . . $14.70 • Varicella saves . . . . . . . . . . . . . $ 5.40 • Inactivated Polio (IPV) saves. . $ 5.45 *direct and indirect savings (including work loss, death, and disability) For every $1 spent*:

4. Childhood Immunization Program Successes • Vaccine-preventable diseases at an all time low • Record high coverage rates • Measles is no longer endemic in the U.S. and Western Hemisphere • Rubella Eliminated

5. Immunization is one of the most important ways parents can protect their children against serious diseases.

6. Comparison of 20th Century Annual Morbidity and Current Morbidity, Vaccine-Preventable Diseases (pre-1990 Vaccines) Numbers in yellow indicate at or near record lows in 2004 †Source: CDC. MMWR April 2, 1999. 48: 242-264 * Provisional 2004 Data

7. Comparison of Pre-Vaccine EraEstimated Annual Morbidity and Current Morbidity,Vaccine-Preventable Diseases (post-1990 Vaccines) N/A = not available

8. We now have the means to protect our nation’s children against 13 diseases that in the past caused great suffering, disability and premature death. 

9. Number of Vaccines in the RoutineChildhood Immunization Schedule 1985 (7) 1995 (10) 2005 (13) Measles Rubella Mumps Diphtheria Tetanus Pertussis Polio Measles Rubella Mumps Diphtheria Tetanus Pertussis Polio Hib (infant) HepB Varicella Measles Rubella Mumps Diphtheria Tetanus Pertussis Polio Hib (infant) HepB Varicella Pneumococcal Disease Influenza Meningococcal

10. Pertussis-related Deaths that have been Reported to CDC This Year • A 52-day-old African-American male from MS. • An infant from MT. • A 2-month-old Native American female from NM. • A 6-week-old infant from OR. • A 96-day-old, white female from WI. • A 4-week-old, white Hispanic female from CA. • A 2-month-old, white Hispanic male from CO. • A 27-day-old white female infant from NC. • A 29-day-old female infant from AZ. • A 3-month-old African-American male infant from FL. • A 13-day-old Hispanic male infant from CA. • A 14-day-old Hispanic female from CA. • A 16-week-old white male from IL. • A 36-day-old white male from WI. • A White male infant from Jefferson Parish, LA

11. Vaccines on the Horizon

12. Percent 100 2010 Target 80 HepB (3+) DTP(3+)† PCV 7 (3+) 60 MMR(1+) Polio (3+) 40 Hib (3+) 20 Varicella (1+) 0 2004 1967 1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000 2003 Vaccine-Specific Coverage Rates Among Pre-school Aged Children †DTP(3+) is not a Healthy People 2010objective. DTP(4) is used to assess Healthy People 2010 objectives. Note: Children in the USIS and NHIS were 24-35 months of age. Children in the NIS were 19-35 months of age. Source: USIS (1967-1985), NHIS (1991-1993) CDC, NCHS, and NIS (1994-December 2003), CDC, NIP and NCHS; No data from 1986-1990 due to cancellation of USIS because of budget reductions0

13. 78 82 78 82 79 85 NH 86 81 MA 89 83 82 86 RI 87 83 81 CT 88 86 86 NJ 83 82 68 80 DE 86 79 83 71 81 87 MD 80 77 81 82 78 DC 83 79 82 82 79 72 82 84 80 82 84 85 75 75 73 89 Estimated Vaccination Coverage with the 4:3:1:3:3* Series, by Coverage Level and StateNational Coverage = 81% VT 85 81  90% 80-89% 70-79%  69% *4+DTP, 3+Polio, 1+MCV, 3+Hib, 3+HepB

14. Estimated Vaccination Coverage with Series Among Children 19-35 Months of Age, National Immunization Survey, 2000 & 2004 Percent

15. Estimated Vaccination Coverage with Series Among Children 19-35 Months of Age, National Immunization Survey, 2000 - 2004 Percent

16. Challenges • Introducing new vaccines • Establishing and maintaining a steady vaccine supply • Vaccine financing • Reducing remaining racial/ethnic disparities in coverage • Addressing unfounded fears about vaccine safety

17. Estimated Vaccination Coverage* Among Children 19-35 Months of Age by Race/Ethnicity† – US, National Immunization Survey, 2000-2004 4:3:1:3:3‡ * Estimate=NA (Not Available) if the unweighted sample size for the numerator was <30 or (CI half width)/Estimate >0.5 or (CI half width)>10 † Self-reported by respondent. Individual racial groups do not include Hispanic children. Children of Hispanic ethnicity may be of any race ‡ 4 or more doses of DTP, 3 or more doses of poliovirus vaccine, 1 or more doses of any MCV, 3 or more doses of Hib, and 3 or more doses of HepB

18. Children Receiving Autism Services by Quarter, California, 2002-2005 California Department of Developmental Services

19. Summary Protecting our Children • Record high coverage rates • 2010 goal of 80% vaccination series complete by age 2 years already achieved • More needs to be done to sustain the immunization system and protect more children

20. Department of Health and Human Services Centers for Disease Control and Prevention

21. Estimated Vaccination Coverage with Series Among Children 19-35 Months of Age, National Immunization Survey, 2000 & 2004

22. Estimated Vaccination Coverage with Individual Vaccines Among Children 19-35 Months of Age, National Immunization Survey, 2002 & 2003

23. Estimated Vaccination Coverage* Among Children 19-35 Months of Age by Race/Ethnicity† – US, National Immunization Survey, 2000-2004 4:3:1:3:3‡ * Estimate=NA (Not Available) if the unweighted sample size for the numerator was <30 or (CI half width)/Estimate >0.5 or (CI half width)>10 † Self-reported by respondent. Individual racial groups do not include Hispanic children. Children of Hispanic ethnicity may be of any race ‡ 4 or more doses of DTP, 3 or more doses of poliovirus vaccine, 1 or more doses of any MCV, 3 or more doses of Hib, and 3 or more doses of HepB