We compared estimates of childhood influenza vaccination coverage by health status, age, and racial/ethnic group across eight consecutive influenza seasons (2004 through 2012) based on two survey systems to assess trends in childhood influenza vaccination coverage in the U.S.
Methods.
We used National Health Interview Survey (NHIS) and National Immunization Survey-Flu (NIS-Flu) data to estimate receipt of at least one dose of influenza vaccination among children aged 6 months to 17 years based on parental report. We computed estimates using Kaplan-Meier survival analysis methods.
Results.
Based on the NHIS, overall influenza vaccination coverage with at least one dose of influenza vaccine among children increased from 16.2% during the 2004–2005 influenza season to 47.1% during the 2011–2012 influenza season. Children with health conditions that put them at high risk for complications from influenza had higher influenza vaccination coverage than children without these health conditions for all the seasons studied. In seven of the eight seasons studied, there were no significant differences in influenza vaccination coverage between non-Hispanic black and non-Hispanic white children. Influenza vaccination coverage estimates for children were slightly higher based on NIS-Flu data compared with NHIS data for the 2010–2011 and 2011–2012 influenza seasons (4.1 and 4.4 percentage points higher, respectively); both NIS-Flu and NHIS estimates had similar patterns of decreasing vaccination coverage with increasing age.
Conclusions.
Although influenza vaccination coverage among children continued to increase, by the 2011–2012 influenza season, only slightly less than half of U.S. children were vaccinated against influenza. Much improvement is needed to ensure all children aged ≥6 months are vaccinated annually against influenza.
References
1.
BurneyLE. Influenza immunization: statement. Public Health Rep1960; 75:944.
2.
Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep2002; 51(RR-3):1–36.
3.
HarperSAFukudaKUyekiTMCoxNJBridgesCB. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP) [published erratum appears in MMWR Morb Mortal Wkly Rep2004; 53(32):743]. MMWR Recomm Rep 2004;53(RR–6):1-40.
4.
SmithNMBreseeJSShayDKUyekiTMCoxNJStrikasRA. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP) [published erratum appears in MMWR Morb Mortal Wkly Rep2006; 55(29):800]. MMWR Recomm Rep 2006;55(RR–10):1-42.
5.
Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008MMWR Recomm Rep 2008; 57(RR-7):1–60.
6.
FioreAEUyekeTMBroderKFinelliLFulerGLSingletonJA Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010 [published erratum appears in MMWR Morb Mortal Wkly Rep 2010; 59(31):993]. MMWR Recomm Rep 2010;59(RR–8):1-62.
7.
GrohskopfLAShayDKThimabukuroTTSokolowLZKeitelWABreseeJS Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2013–2014 [published erratum appears in MMWR Morb Mortal Wkly Rep 2013; 62(45):906]. MMWR Recomm Rep 2013;62(RR–7):1-43.
8.
Use of influenza A (H1N1) 2009 monovalent vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009MMWR Recomm Rep 2009; 58(RR-10):1–8.
9.
Centers for Disease Control and Prevention (US). National Health Interview Survey: questionnaires, datasets, and related documentation: 1997 to the present [cited 2013 Apr 12]. Available from: URL: http://www.cdc.gov/nchs/nhis/quest_data_related_1997_forward.htm
Centers for Disease Control and Prevention (US). Seasonal influenza (flu): flu vaccination coverage, United States, 2012–13 influenza season [cited 2014 May 18]. Available from: URL: http://www.cdc.gov/flu/fluvaxview/coverage-1213estimates.htm
LuP-JSantibanezTAWilliamsWWZhangJDingHBryanL Surveillance of influenza vaccination coverage—United States, 2007–08 through 2011–12 influenza seasons. MMWR Surveill Summ2013; 62(SS-4):1–29.
15.
SantibanezTASingletonJASantibanezSSWortleyPBellBP. Socio-demographic differences in opinions about 2009 pandemic influenza A (H1N1) and seasonal influenza vaccination and disease among adults during the 2009–2010 influenza season. Influenza Other Respir Dis2012; 7:383–92.
Centers for Disease Control and Prevention (US). Season influenza (flu): final state-level monthly cumulative influenza vaccination coverage estimates for the 2009–10 season—United States, August 2009 through May2010 [cited 2013 Nov 7]. Available from: URL: http://www.cdc.gov/flu/professionals/vaccination/reporti0910/reportI0910
Centers for Disease Control and Prevention (US). Final state-level influenza vaccination coverage estimates for the 2010–11 season— United States, National Immunization Survey and Behavioral Risk Factor Surveillance System, August 2010 through May2011 [cited 2013 Nov 7]. Available from: URL: http://www.cdc.gov/flu/professionals/vaccination/coverage_1011estimates.htm
20.
SmithPJBattagliaMPHugginsVJHoaglinDCRodenAKhareM Overview of the sampling design and statistical methods used in the National Immunization Survey. Am J Prev Med2001;20 (4 Suppl):17–24.
21.
SAS Institute, Inc. SAS®: Version 9.3 for Windows. Cary (NC): SAS Institute, Inc.; 2011.
22.
Research Triangle Institute, Inc. SUDAAN®: Release 11.0. Research Triangle Park (NC): Research Triangle Institute, Inc.; 2012.
23.
PoehlingKAEdwardsKMGriffinMRSzilagyiPGStaatMAIwaneMK The burden of influenza in young children, 2004–2009. Pediatrics2013; 131:207–16.
24.
WalkerATSmithPJKolasaM. Reduction of racial/ethnic disparities in vaccination coverage, 1995–2011. MMWR Surveill Summ2014; 63:7–12.
BrownCClayton-BoswellHChavesSSPrillMMIwaneMKSzilagyiPG Validity of parental report of influenza vaccination in young children seeking medical care. Vaccine2011; 29:9488–92.
29.
Centers for Disease Control and Prevention (US). Behavioral Risk Factor Surveillance System: questionnaires [cited 2013 Apr 12]. Available from: URL: http://www.cdc.gov/brfss/questionnaires.htm#about
30.
Estimated influenza vaccination coverage among adults and children—United States, September 1, 2004-January 31, 2005MMWR Morb Mortal Wkly Rep 2005; 54(12):304–7.
Centers for Disease Control and Prevention (US). Results from the March 2011 National Flu Survey—United States, 2010–11 influenza season [cited 2013 Nov 7]. Available from: URL: http://www.cdc.gov/flu/pdf/fluvaxview/fluvacsurvey.pdf
Brief report: influenza vaccination coverage among children aged 6–23 months—six immunization information system sentinel sites, United States, 2005–06 influenza season. MMWR Morb Mortal Wkly Rep2006; 55(49):1329–30.
35.
NowalkMPZimmermanRKLinCJKoFSRaymundMHobermanA Parental perspectives on influenza immunization of children aged 6 to 23 months. Am J Prev Med2005; 29:210–4.
36.
ShinallMCJrPlosaEJPoehlingKA. Validity of parental report of influenza vaccination in children aged 6 to 59 months of age. Pediatrics2007; 120:e783–7.
37.
LuPDorellCYankeyDSantibanezTASingletonJA. A comparison of parent and provider reported influenza vaccination status of adolescents. Vaccine2012; 30:3278–85.
38.
YooBKBerryAKasajimaMSzilagyiPG. Association between Medicaid reimbursement and child influenza vaccination rates. Pediatrics2010; 126:e998–1010.
