Er. Zell et al., LOW VACCINATION LEVELS OF US PRESCHOOL AND SCHOOL-AGE-CHILDREN - RETROSPECTIVE ASSESSMENTS OF VACCINATION COVERAGE, 1991-1992, JAMA, the journal of the American Medical Association, 271(11), 1994, pp. 833-839
Objective.-To obtain estimates on (1) the percentage of children who w
ere up-to-date on the recommended childhood vaccination series, (2) th
e percentage of children who were age-appropriately immunized, and (3)
coverage levels by individual vaccines. Design.-Vaccination levels we
re estimated by conducting retrospective immunization coverage surveys
of the school health records of children entering kindergarten or fir
st grade in the 1990-1991 or 1991-1992 school year. A multistage clust
er survey design was used. Setting.-Survey sites were selected from am
ong the 60 largest urban areas in the United States. One small city an
d one rural area were selected for comparison. Results.-By their secon
d birthday, 11% to 58% (median, 44%) of the children were fully vaccin
ated. Stricter measurement criteria lowered coverage levels further. C
ompleted series levels at school entry were 71% to 96% (median, 87%).
Conclusions.-Vaccination levels at the second birthday were far below
the goal for the year 2000. All health providers need to administer va
ccines according to the recommended schedule.