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

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. INCPOVlabels = Poverty level c(1=“Aboce poverty, > 75K”, 2=“Above poverty, <= 75K”, 3=“Below poverty”, 4=“Unknown”)
6. SEX = Sex of child
7. RACE_K = Race of child
8. RACEETHK = Race/Ethnicity of child
9. STATE = True state of residence (state fips code) CODE)

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

Description 2019 % 2020 %
Total Children 33799 100 36750 100.0
Verified Info 16562 49 19593 53.3

The NIS-Child measures coverage of the following recommended vaccinations:

1. Diphtheria, Tetanus toxoids, and acellular pertussis (DTaP/DT/DTP)


Routine vaccination:

5-dose series at age 2, 4, 6, 15–18 months,

  • 4–6 years Prospectively: Dose 4 may be administered as early as age 12 months if at least 6 months have elapsed since dose 3.

  • Retrospectively: A 4th dose that was inadvertently administered as early as age 12 months may be counted if at least 4 months have elapsed since dose 3.

Variables

  1. DDTP1: Age in days of prov-reptd DT - containing shot from #1 to #9.
  2. DTP1_AGE: Age in months of prov-reptd DT-containing shot #1 to #9.


Tables summary

Table 1.1

Children who register the 3th and 4th dose before the age of 6 and 12 months respectively.

DTaP/DT/DTP
Dose 2019 2020 Difference
Total Success % (95% CI)1,2 Total Success % (95% CI)1,2 % (95% CI)
Dose 3 16398 13472 82.2 (81.6 to 82.7) 19456 16039 82.4 (81.9 to 83) -0.2 (-1.1 to 0.5)
Dose 4 16398 483 2.9 (2.7 to 3.2) 19456 552 2.8 (2.6 to 3.1) 0.1 (-0.2 to 0.5)
1 Proportion of success among the total verified information.
2 Children who receive the vaccine at the recommended age.

Table 1.2

Children who do not register vaccine doses at the any age.

Missing Vaccine Dose
Dose 2019 2020
Total1 %2 Total %
Dose 1 413 3 398 2
Dose 2 571 3 576 3
Dose 3 811 5 824 4
Dose 4 2111 13 2358 12
Dose 5 16165 99 19130 98
1 Total number of children who do not register the vaccine dose at any age
2 Percentages are computed over the total number of children with verified information in that year


Histogram

Frequency of ages at which it is recorded that children obtained their dose of vaccine.

Figure 1.1: Dose 3

Figure 1.2: Dose 4

2. Poliovirus vaccine (Polio)


3. Measles or Measles-Mumps-Rubella vaccine (MMR)

Routine vaccine:
2-dose series at age 12–15 months, age 4–6 years.
MMR or MMRV may be administered.

Note: For dose 1 in children age 12–47 months, it is recommended to administer MMR and varicella vaccines separately. MMRV may be used if parents or caregivers express a preference.

Related Variables

  1. DMMR1: Age in days of prov-reptd measles-containing shot from #1 to #9.

  2. DMP1: Age in days of prov-reptd Mumps-only shot from #1 to #9.

  3. DRB1: Age in days of prov-reptd Rubella-only shot from #1 to #9.

  4. DMPR1: Age in days of prov-reptd (Mumps/Ruebbella)-only shot from #1 to #9.

  5. MMR1_AGE: Age in months of prov-reptd measles-containing shot #1-#9.

  6. MP1_AGE:Age in months of prov-reptd Mumps-only shot #1-#9.

  7. RB1_AGE: Age in months of prov-reptd Rubella-only

  8. MPR1_AGE: Age in months of prov-reptd (Mumps/Ruebbella)-only.

  9. XMMRTY1:Measles-containing vaccination #! type code.

  10. XVRCTY1:Varicella-containing vaccination #1

I’m ussing only the variable MMR1_AGE and filter all children who register the dose 1 before the age of 15 months. Holly et al. Take this variable as children who might have been vaccinated with measles, mumps, rubella, and varicella combination vaccine.

Below are the vaccine types of those children who have the dose 1 between 12-15 months. I did not discriminate between vaccines. Should I do it?

VM- MMR-VARICELLA
30- MMR
31- MEASLES ONLY
MM- MCV-UNKNOWN

Table 3.1.

Children who register the 2nd dose before 15 months.

MMR
Dose 2019 2020 Difference
Total Success % (95% CI)1,2 Total Success % (95% CI)1,2 % (95% CI)
Dose 1 16398 13868 84.6 (84 to 85.1) 19456 16638 85.5 (85 to 86) -0.9 (-1.7 to -0.2)
1 Proportion of success among the total verified information.
2 Children who receive the vaccine at the recommended age.

Table 3.2

Children who do not register vaccine doses at the any age.

Missing Vaccine Dose
Dose 2019 2020
Total1 %2 Total %
Dose 1 1002 6 1011 5
1 Total number of children who do not register the vaccine dose at any age
2 Percentages are computed over the total number of children with verified information in that year

Histogram

Frequency of ages at which it is recorded that children obtained their dose of vaccine.

Figure 3.1: Dose 1

4. Haemophilus influenzae type b (Hib)

Routine vaccine:
ActHIB®, Hiberix®, Pentacel®, or Vaxelis®: 4-dose series (3 dose primary series at age 2, 4, and 6 months, followed by a booster dose* at age 12–15 months)
* Vaxelis® is not recommended for use as a booster dose. A different Hib-containing vaccine should be used for the booster dose.

  • PedvaxHIB®: 3-dose series (2-dose primary series at age 2 and 4 months, followed by a booster dose at age 12–15 months).

Variables

  1. DHIB1: Age in days of prov-reptd HIP-containing shot #1-#9
  2. HIB1_AGE: Age in months of prov-reptd HIB-containing shot #1-#9.
  3. XHIBTY1: Hib Containing vaccination #1 Type Code

Holly et al. Defined Hib primary series: receipt of ≥2 or ≥3 doses, depending on product type received. full series: primary series and booster dose, which includes receipt of ≥3 or ≥4 doses, depending on product type received

The number of doses depend on the type of vaccine. Those are the types register in the dataset:

HG- HIB (GLAXOSMITHKLINE)
HI- HIB-UNKNOWN
HM- HIB (MERCK)
HS- HIB (SANOFI)
HY- HIB-MENCY
44- HIB ONLY-UNKNOWN
43- HEPB-HIB
05- DTP-HIB
07- DTAP-HIB
H2- HIB (SANOFI OR GLAXOSMITHKLINE)

I’m not sure how to clasified them.

5. Hepatitis B (HepB)


Routine vaccination

  • 3-dose series at age 0, 1–2, 6–18 months
  • Infants who did not receive a birth dose should begin the series as soon as feasible.
  • Administration of 4 doses is permitted when a combination vaccine containing HepB is used after the birth dose.
  • Minimum age for the final (3rd or 4th ) dose: 24 weeks.
  • Minimum intervals: dose 1 to dose 2: 4 weeks / dose 2 to dose 3: 8 weeks / dose 1 to dose 3: 16 weeks.

Variables

  1. HEP_BRTH = Hepatitis B-containing shot given at birth flag.
  2. HEP_FLAG = Hepatitis B birth shot date imputation flag.
  3. P_NUHEPX = Number of hepatitis B-only shots by 36 months of age determined from provider info, excluding any vaccination after the HH interview date.
  4. U2D_HEP = Birth dose hepatitis B-containing given from birth to day 2 flag.
  5. U3D_HEP = Birth dose hepatitis B-containing given from birth to day 3 flag.
  6. DHEPB1 = Age in days of prov-reptd hepatitis B-containing shot #1 to #9.
  7. HEP1_AGE = Age in months of prov-reptd hepatitis B-containing shot #1 to #9.

According to Holly et al.
Birth dose: One dose HepB administered from birth through age 3 days.

Table 5.1.

Children who take the 3th dose before 18 months

HepB
Dose 2019 2020 Difference
Total Success % (95% CI)1,2 Total Success % (95% CI)1,2 % (95% CI)
Birth dose 16398 13413 81.8 (81.2 to 82.4) 19456 16288 83.7 (83.2 to 84.2) -1.9 (-2.7 to -1.1)
>= Dose 3 16398 15041 91.7 (91.3 to 92.1) 19456 17992 92.5 (92.1 to 92.8) -0.8 (-1.3 to -0.2)
1 Proportion of success among the total verified information.
2 Children who receive the vaccine at the recommended age.

Table 5.2. Missing birth dose

Children who do not register vaccine doses at the any age.

Missing Vaccine Dose
Dose 2019 2020
Total1 %2 Total %
Dose 1 305 2 318 2
1 Total number of children who do not register the vaccine dose at any age
2 Percentages are computed over the total number of children with verified information in that year

Table 5.3. Missing Dose 3

Missing Vaccine Dose
Dose 2019 2020
Total1 %2 Total %
Dose 3 1093 7 1173 6
1 Total number of children who do not register the vaccine dose at any age
2 Percentages are computed over the total number of children with verified information in that year

Histogram

Frequency of ages at which it is recorded that children obtained their dose of vaccine.

Figure 5.1: Birth dose

Figure 5.2. Dose 3

6. Varicella zoster (chickenpox) (VAR)


Routine vaccination
* 2-dose series at age 12–15 months, 4–6 years VAR or MMRV may be administered

  • Dose 2 may be administered as early as 3 months after dose 1 (a dose inadvertently administered after at least 4 weeks may be counted as valid)


Note: For dose 1 in children age 12–47 months, it is recommended to administer MMR and varicella vaccines separately. MMRV may be used if parents or caregivers express a preference.

Variables

  1. DVRC1: Age in days of prov-reptd varicella-containing shot #1-#9
  2. VRC1_AGE: Age in months of prov-reptd Varicella-containing shot #1-#9.
  3. XVRCTY1: Varicella-containing vaccination #1-9 type code.

According to Holly et al.
Includes children who might have been vaccinated with measles, mumps, rubella, and varicella combination vaccine

Types of vaccenes

VA- VARICELLA-UNKNOWN
VM- MMR-VARICELLA
VO- VARICELLA-ONLY

Table 6.1.

Children who take the 1st dose before 15 months.

Varicella (VAR)
Dose 2019 2020 Difference
Total Success % (95% CI)1,2 Total Success % (95% CI)1,2 % (95% CI)
>=Dose1 16398 13662 83.3 (82.7 to 83.9) 19456 16490 84.8 (84.2 to 85.3) -1.5 (-2.2 to -0.7)
1 Proportion of success among the total verified information.
2 Children who receive the vaccine at the recommended age.

Table 6.2.

Children who do not register vaccine doses at the any age.

Missing Vaccine Dose
Dose 2019 2020
Total1 %2 Total %
Dose 1 1139 7 1190 6
1 Total number of children who do not register the vaccine dose at any age
2 Percentages are computed over the total number of children with verified information in that year

Histogram

Frequency of ages at which it is recorded that children obtained their dose of vaccine.

Figure 6.1: Dose 1.

7. Pneumococcal conjugate (PCV)


Rountine vaccination with PCV13
4-dose series at age 2, 4, 6, 12–15 months

8. Hepatitis A (HepA)


Routine vaccine:
2-dose series (minimum interval: 6 months) at age 12–23 months.
Variables

  1. DHEPA1: Age in days of prov-reptd hepatitis A containing shot #1 to # 9
  2. HEA1_AGE: Age in months of prov-reptd hepatitis A-containing shot #1 to 9.

9. Rotavirus (ROT)


Routine vaccination

  • Rotarix®: 2-dose series at age 2 and 4 months
  • RotaTeq®: 3-dose series at age 2, 4, and 6 months
    If any dose in the series is either RotaTeq® or unknown, default to 3-dose series.

10. Influenza (Flu)


SUMMARY.

Estimated vaccination coverage by age 35 months according to the National Immunization Survey-Child, United States, 2019–2020

Summary
Dose 2019 2020 Difference
Total Success % (95% CI)1,2 Total Success % (95% CI)1,2 % (95% CI)
DDTP
Dose 3 16398 13472 82.2 (81.6 to 82.7) 19456 16039 82.4 (81.9 to 83) -0.2 (-1.1 to 0.5)
Dose 4 16398 483 2.9 (2.7 to 3.2) 19456 552 2.8 (2.6 to 3.1) 0.1 (-0.2 to 0.5)
MMR
Dose 1 16398 13868 84.6 (84 to 85.1) 19456 16638 85.5 (85 to 86) -0.9 (-1.7 to -0.2)
HepB
Birth dose 16398 13413 81.8 (81.2 to 82.4) 19456 16288 83.7 (83.2 to 84.2) -1.9 (-2.7 to -1.1)
>= Dose 3 16398 15041 91.7 (91.3 to 92.1) 19456 17992 92.5 (92.1 to 92.8) -0.8 (-1.3 to -0.2)
VAR
>=Dose1 16398 13662 83.3 (82.7 to 83.9) 19456 16490 84.8 (84.2 to 85.3) -1.5 (-2.2 to -0.7)
1 Proportion of success among the total verified information.
2 Children who receive the vaccine at the recommended age.