The NIS-Child is a national survey that uses random digit dialing of both landlines and cell phones to identify households with children 19-35 months of age.

Eligibility for vaccination was determined based on Child and Adolescent Immunization Schedule

The analysis was limited to children with provider-verified immunizations to improve the accuracy of missed opportunity measurements and determination of vaccination coverage.

1. General information

1. SEQNUMC = Unique child identifier
2. PDAT = Child has adequate provider data
3. D7 = Consent to obtein child’s immunization records from provider
4. AGEGRP = Age category of child (1 = 19-23, 2 =24-29,3= 30-35 Months)
5. INCPOV1 = Poverty level c(1=“Aboce poverty, > 75K”, 2=“Above poverty, <= 75K”, 3=“Below poverty”, 4=“Unknown”)
6. SEX = Sex of child
7. RACEETHK = Race/Ethnicity of child
8. STATE = True state of residence (state fips code)
9 EDUC1 = Education of mother categories
labels=c(“< 12 Years”, “12 Years”, “> 12 Years,not College graduate”, “College graduate”)
10. M_AGEGRP2: Age of mother categories.

Description 2019 % 2020 %
Total Children 33799 100.0 36750 100.0
Verified Info 16398 48.5 19456 52.9

Vaccines

1. Rotavirus (ROT)
2. Poliovirus vaccine (IPV)
3. Measles or Measles-Mumps-Rubella vaccine (MMR)
4. Hepatitis B (HepB)
5. Varicella zoster (chickenpox) (VAR)
6. Pneumococcal conjugate (PCV)
7. Hepatitis A (HepA)
8. Haemophilus influenzae type b (Hib)
9. Diphtheria, tetanus, and pertussis (DTaP)
10. Influenza (FLU)

Missing at least one vaccine.

Percentage of children who do not register vaccine doses at any age.

Missing Vaccination
Vaccine/Dose 2019 2020 % (95% CI) p-value1
% (95% CI) % (95% CI)
ROT 9.24 (8.8,9.7) 7.93 (7.6,8.3) -1.3 (-1.9,-0.7) 0.00001
IPV 2.9 (2.6,3.2) 2.4 (2.2,2.6) -0.5 (-0.8,-0.2) 0.00332
MMR 6.11 (5.7,6.5) 5.2 (4.9,5.5) -0.9 (-1.4,-0.4) 0.00020
HepB 1.86 (1.7,2.1) 1.63 (1.5,1.8) -0.2 (-0.5,0) 0.10537
VAR 6.95 (6.6,7.3) 6.12 (5.8,6.5) -0.8 (-1.3,-0.3) 0.00158
PCV 2.95 (2.7,3.2) 2.51 (2.3,2.7) -0.4 (-0.8,-0.1) 0.01159
HepA 9.95 (9.5,10.4) 8.73 (8.3,9.1) -1.2 (-1.8,-0.6) 0.00008
HIB 2.69 (2.4,2.9) 2.3 (2.1,2.5) -0.4 (-0.7,-0.1) 0.01812
DTaP 2.52 (2.3,2.8) 2.05 (1.9,2.3) -0.5 (-0.8,-0.2) 0.00293
FLU 23.43 (22.8,24.1) 19.81 (19.3,20.4) -3.6 (-4.5,-2.8) 0.00000
1 Differences were assessed with a z-test of proportions.

Number of missing vaccine.

For the tables and figures from now on we join the base of 2019 and the base of 2020 and we remove the duplicate children.
This table shows the proportion by race/ethnicity, poverty, and mother’s education of children who miss 0, 1, 2… doses of the first dose of recommended vaccines. (What I observed is that if they don’t have the first dose, they don’t have any).
If a child is missing 1 vaccine, it means that he has the first dose of the other 9 vaccines and so on for the others.

Total sample N= 27559
Dupplicated 8432
Description Total % Missing Vaccines
0 1 2 3 4 5 6 7 8 9 All
Race/Ethnicity
Black 1955 7.1 60.7 24.8 5.5 2.1 2.3 0.7 0.4 0.1 0.2 1.5 1.7
Hispanic 5678 20.6 68 21.2 2.8 1.7 2.2 0.4 0.2 0.1 0.1 2.2 1.1
Multiple race 3746 13.6 72.7 17.4 3 1.3 2 0.5 0.1 0.1 0.1 1.5 1.2
White 16180 58.7 74 16.5 3.5 1.4 1.5 0.4 0.3 0.1 0.1 1.1 1
Poverty Status
Above poverty, <= $75K 8284 30.1 66.4 21.4 4.1 1.6 2.2 0.6 0.4 0.2 0.2 1.6 1.3
Above poverty, > $75K 12934 46.9 80.1 12.9 2.5 1.2 0.9 0.2 0.2 0.1 0 1 0.8
Below poverty 5343 19.4 60.1 25.8 4.5 2 3.1 0.8 0.2 0.1 0.1 2 1.3
Unknown 998 3.6 66 19.8 4 2.2 1.7 0.4 0.1 0.1 0.6 2.8 2.2
Mother's Education
< 12 years 2132 7.7 62.5 23.7 3.8 2 2.7 0.8 0.3 0.2 0.2 2 1.9
> 12 years,not a college graduate 6996 25.4 65.1 22.6 4.2 1.7 2.3 0.5 0.3 0.1 0.1 1.7 1.3
12 years 4433 16.1 61.8 24.2 5 2.1 2.4 0.9 0.2 0.1 0.2 1.7 1.4
College graduate 13998 50.8 79.4 13.3 2.5 1.1 1.2 0.2 0.2 0.1 0.1 1.1 0.8

Distribution time of the last dose

darkblue = correspond to the interval where the child has to receive the last dose of each vaccine.
red: Children who received the last vaccine after the recommended period.
lightblue:Children who received the last vaccine before the recommended period.
The X axis represents the age of the child when he received the last dose of the vaccine and the Y axis corresponds to the total number of children who received the doses at the same age. 

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Maps

To create the maps, we verified the children who recorded the last dose of each vaccine (they have a complete schedule).
Percentages correspond to the total children with # doses by state over the total children by state.

The dark color corresponds to the highest coverage percentages.