Vaccination Coverage: How Are We Doing?

October 2, 2013

Vaccination Coverage: How Are We Doing?

  1. Deborah Lehman, MD

Vaccine rates remain high but the number of measles cases in the U.S. is increasing.

  1. Deborah Lehman, MD

The National Immunization Survey (NIS) monitors vaccine coverage in children ages 19 to 35 months. Data from 2012 released by the CDC indicates that vaccination rates for measles, mumps, and rubella (MMR); polio; hepatitis B; and varicella are reaching the Healthy People 2020 target rate of 90%. Persistent differences in coverage remain between children living above and below the poverty line for newer vaccines (e.g., hepatitis A and rotavirus) and for vaccinations that require multiple doses (e.g., diphtheria, tetanus, pertussis [DTaP]). Because the methodology of the NIS changed, these results serve as a new baseline for future surveys.

An accompanying report indicates that vaccination coverage varies by state. From January through August of 2013, 159 cases of measles were reported to the CDC during 8 outbreaks from 16 states and New York City. This represents a significant increase from previous years and the second highest number of cases since 2000 (220 cases were reported in 2011). Most cases (92%) were in unvaccinated individuals, 79% of whom were unvaccinated for philosophical reasons. Nearly all cases (99%) could be traced to an imported case, and half of these were imported from Europe. One outbreak involved 58 people in two Brooklyn neighborhoods and was traced to a case of measles in a 17-year-old unvaccinated boy who acquired his infection in London. Another outbreak involved 22 individuals in a North Carolina community with low vaccination rates and was traced to an unvaccinated traveler returning from India.


The news that vaccination rates remain high nationwide is encouraging. However, the measles outbreaks remind us that outbreaks occur when vaccination rates drop below levels that ensure herd immunity. European countries as well as developing countries are important sources of measles importation.

Editor Disclosures at Time of Publication

  • Disclosures for Deborah Lehman, MD at time of publication Nothing to disclose


Reader Comments (1)

ROBERT BONE Physician, Pediatrics/Adolescent Medicine, opd

rural TN Ranking ?

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