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Tony Aragon, MS Epidemiologist Immunization Branch May 20, 2010

Vaccine Coverage . Tony Aragon, MS Epidemiologist Immunization Branch May 20, 2010 . Vaccine Coverage. Objective Explain the differences between the different vaccination coverage levels for children, adolescents, and adults Review National and State Surveys Data collected

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Tony Aragon, MS Epidemiologist Immunization Branch May 20, 2010

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  1. Vaccine Coverage Tony Aragon, MS Epidemiologist Immunization Branch May 20, 2010

  2. Vaccine Coverage • Objective • Explain the differences between the different vaccination coverage levels for children, adolescents, and adults • Review National and State Surveys • Data collected • What is measured • Ages • Area • When

  3. Current Immunization Data Sources

  4. Vaccine Coverage…....Outline • Surveys • National Immunization Survey (NIS) • Texas County Retrospective Immunization School Survey (TCRISS) • Texas School Immunization Validation Survey • Texas Childcare Immunization Assessment • The Annual Survey of Immunization Status • The Behavioral Risk Factor Surveillance System (BRFSS)

  5. Vaccine Coverage for Children • 2008 National Immunization Survey (NIS) • Texas County Retrospective Immunization School Survey (TCRISS) • 2008-09 Annual Report of Immunization Status • 2007 Texas School Immunization Validation Survey • 2007 Texas Childcare Immunization Assessment

  6. Vaccine Coverage for Children • National Immunization Survey (NIS) • Provides vaccination coverage levels of children aged 19 – 35 months • Provides immunization coverage by state, select local areas as well as the nation • Bexar Co. • City of Houston • Dallas Co. • El Paso Co. • Provides a national standard for vaccine coverage • 2008 – 4:3:1:3:3:1 vaccines series • 2009 - 4:3:1:3:3:1:4, pneumococcal conjugate vaccine will be added.

  7. 4:3:1:3:3:1* Estimated Vaccination Coverage Levels in Children 19-35 Months, US and Texas, NIS 2002-2008 *4:3:1:3:3:1 – 4+ doses DTP, 3+ doses Polio, 1+ dose MMR, 3+ doses of Hib, 3+ doses Hep B, and 1+ doses of varicella

  8. Estimated Vaccination Coverage Levels in Children19-35 Months by State and Local Area, NIS 2008* *Based on 2008 US NIS Report (Q1/2008-Q4/2008)

  9. Vaccine Coverage for Children • Texas County Retrospective Immunization School Survey (TCRISS) • Provides county level estimates of vaccination coverage • School-based study that measures vaccination coverage levels of kg retrospectively at 24 months • Measures Hep A vaccine, prospectively • Fulfills a need for county specific vaccination coverage level estimates

  10. Vaccine Coverage for Children • 2008-09 Annual Report of Immunization Status • Texas requires a report of immunization status annually from public schools and accredited private schools • Texas Administrative Code,Title 25 Health Services, §§97.61-97.72 • The Annual Report of Immunization Status is a self report survey • Used to measure immunization coverage among students entering kindergarten and middle school (7th grade)

  11. Percent of Texas Kindergarten Students Completely Vaccinated by Vaccine Antigen, 2008-09 Annual Report of Immunization Status

  12. Vaccine Coverage for Children • 2007 Texas School Immunization Validation Survey • Conducted annually to validate the results of the Annual Report of Immunization Status • 70 public schools with kindergarteners and seventy schools with 7th graders are randomly selected statewide • Statewide vaccination coverage levels are available for Kindergarten and 7th grade students attending public school in Texas

  13. Estimated Coverage Levels of Students in Texas Public School for Kindergarten Students, 2007 Texas School Immunization Validation Survey

  14. Vaccine Coverage for Children • 2007 Texas Childcare Immunization Assessment • Conducted biennially to assess vaccination coverage levels of children attending a childcare facility • Used to monitor compliance vaccine requirements at licensed child care centers (LCCC) and registered child care homes (RCCH) in Texas • Approximately 2400 children from approximately 120 child-care facilities per HSR are selected and examined for immunizations and their dates of administration • Statewide and regional vaccination coverage levels are estimated for children ages 19 – 59 months of age attending childcare facilities in Texas

  15. Estimated Vaccination Coverage Levels Among Child Care Attendees by Health Service Region and Texas, 4:3:1:3:3:1* Series, 2007 Texas Childcare Immunization Assessment

  16. Vaccination Coverage Level Estimates Among Child Care Attendees by HSR and Texas, 4 Doses of DTaP 2007 Texas Childcare Immunization Assessment

  17. Vaccination Coverage for Adolescents • 2008 NIS-Teen Survey • 2007 Texas School Immunization Validation • 2008-09 Annual Report of Immunization Status

  18. Vaccine Coverage for Adolescents • National Immunization Survey (NIS)-Teen • Provides an on-going, consistent data set for analyzing vaccination levels among adolescents 13 to 17 years old • The NIS-Teen provides national, state, and selected area estimates of vaccination coverage • Bexar Co. • City of Houston • Rest of State • Provides a national standard for vaccine coverage among adolescents

  19. Estimated Vaccination Coverage Among Adolescents 13-17 Years of Age, 2008 National Immunization Survey-Teen

  20. Estimated Vaccine Coverage Level in Texas Public School for 7th Grade Students, 2007 Texas School Immunization Validation Survey

  21. Percent of 7th Grade Students Completely Vaccinated with Individual Vaccine by Health Service Region, 2008-09 Annual Report of Immunization Status

  22. Vaccination Coverage for Adults • The Behavioral Risk Factor Surveillance System (BRFSS)

  23. Adult Immunization Data Sources • The Behavioral Risk Factor Surveillance System (BRFSS) • BRFSS is an ongoing data collection program designed to measure behavioral risk factors in the adult population • 18 years of age or older • Provides adult immunization rates on • Influenza • Pneumococcal

  24. Flu Vaccine Coverage Level, US & TX BRFSS 2002-2009, 65 Years and Older

  25. Flu Vaccine Coverage Level, US & TX18 Years and Older, BRFSS 2003-2009

  26. Pneumonia Shot, US & TX65 Years and Older, BRFSS 2002-2009

  27. Other Immunization Data • Conscientious Exemptions • Conscientious Objections (COs)

  28. Sources for Conscientious Exemption Data • Number of affidavit forms requested • Number of requests • Number of children for whom exemptions are requested • Number of affidavit forms per child • Zip Code • Number of exemptions reported via school surveys & child-care audits

  29. Yearly Comparison of the Number of Individuals Requesting Conscientious Exemptions, 2004 - 2009

  30. 2008-09 Annual Report of Immunization Status: Kindergarten Conscientious Exemptions

  31. 2008-09 Annual Report of Immunization Status: 7th Grade Conscientious Exemptions

  32. Annual Report of Immunization Status: Total Number of Conscientious Exemptions Reported, School Year 2003-2008

  33. Annual School Report: Total Number of Conscientious Exemptions Reported, School Year 2003-2008

  34. Independent School Districts and Accredited Private Schools Reporting Conscientious Exemptions by County, School Year 2007-08 Data Source: Annual School report of Immunization Status, School Year 2007-08 DSHS, Immunization Branch Disclaimer: This data is self reported data and may vary from year to year. Map Created by: DSHS Center for Health Statistics

  35. Questions? Tony Aragon, MS Epidemiologist Tony.aragon@dshs.state.tx.us

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