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. 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)

Description 2019 % 2020 %
Total Children 33799 100 36750 100.0
Verified Info 16398 48.5 19456 52.9
Age 24-35 11318 33.5 13895 37.8
After remove dup ID 9732 26.5

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

1. 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.
    Variables
  1. DROT1: Age in days of prov-reptd rotaviurs-containing shots #1-9.
  2. ROT1_AGE: Age in months of prov-reptd rotavirus-containing shot #1-9.
  3. XROTTY1: Rotavirus-containing vaccination #1

Types of vaccines

RG- ROTARIX (GSK)
RM- ROTATEQ (MERCK)
RO- ROTAVIRUS-UNKNOWN

In Holly et al. Includes ≥2 doses of Rotarix monovalent rotavirus vaccine (RV1), or ≥3 doses of RotaTeq pentavalent rotavirus vaccine (RV5); if any dose in the series is RotaTeq or unknown, a 3-dose series was assumed. The maximum age for the final rotavirus dose is 8 months, 0 days.

filtre los que recibieron la primera dosis con RG, pero al revisar la segunda dosis aparece que algunos de ninos tienen su segunda dosis con RM o RO, afecta eso el numero de dosis?}


En lugar de verificar que la dosis fuera recibida antes de los 24 meses lo hice antes de los 8 meses como lo indica el CDC y el articulo de Holly et al.

Table 1.1.

ROT
Vaccine/Dose Total_year1 Success_year1 2019 Total_year2 Success_year2 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
Rotavirus (by age 8 mos) 11318 8950 79.1 (78.3 to 79.8) 9732 7733 79.5 (78.6 to 80.3) -0.4 (-1.5 to 0.7)

Table 1.2

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

Missing Vaccine Dose
Dose 2019 2020 Difference
Total Missing vaccine1 95% CI Total Missing vaccine1 95% CI Difference
Rotavirus 11318 1072 9.47 (8.9 to 10) 9732 782 8.04 (7.5 to 8.6) 1.4 (0.7 to 2.2)
1 Total number of children who do not register the vaccine dose at any age

2. Poliovirus vaccine (IPV)


Routine vaccination

  • 4-dose series at ages 2, 4, 6–18 months, 4–6 years; administer the final dose on or after age 4 years and at least 6 months after the previous dose.

  • 4 or more doses of IPV can be administered before age 4 years when a combination vaccine containing IPV is used. However, a dose is still recommended on or after age 4 years and at least 6 months after the previous dose.

Variables

  1. DPOLIO1: Age in days of prov-reptd polio-containing shot #1.
  2. POL1_AGE: Age in months of prov-reptd polio-containig shot #1-9.

Table 2.1.

Children who register the 3th dose <= 24 months of age.

POLIO (IPV)
Vaccine/Dose Total_year1 Success_year1 2019 Total_year2 Success_year2 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
IPV >=Dose 3 11318 10615 93.8 (93.3 to 94.2) 9732 9209 94.6 (94.2 to 95.1) -0.8 (-1.5 to -0.2)

Table 2.2

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

Missing Vaccine Dose
Dose 2019 2020 Difference
Total Missing vaccine1 95% CI Total Missing vaccine1 95% CI Difference
IPV 11318 335 2.96 (2.7 to 3.3) 9732 223 2.29 (2 to 2.6) 0.7 (0.2 to 1.1)
1 Total number of children who do not register the vaccine dose at any age

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

Below are the vaccine types of those children who have the dose 1 before 24 months. I did not discriminate between vaccines. Should I do it?

Holly et al. Take this variable as children who might have been vaccinated with measles, mumps, rubella, and varicella combination vaccine.

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

Table 3.1.

Children who register the 1st dose <= 24 months of age.

MMR
Vaccine/Dose Total_year1 Success_year1 2019 Total_year2 Success_year2 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
MMR (>=Dose 1) 11318 10508 92.8 (92.4 to 93.3) 9732 9184 94.4 (93.9 to 94.8) -1.6 (-2.2 to -0.9)

Table 3.2

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

Missing Vaccine Dose
Dose 2019 2020 Difference
Total Missing vaccine1 95% CI Total Missing vaccine1 95% CI Difference
MMR 11318 647 5.72 (5.3 to 6.2) 9732 455 4.68 (4.3 to 5.1) 1 (0.4 to 1.6)
1 Total number of children who do not register the vaccine dose at any age

4. 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 4.1.

Children who take the 3th dose before 18 months

HepB
Vaccine/Dose Total_year1 Success_year1 2019 Total_year2 Success_year2 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
Birth dose 11318 8722 77.1 (76.3 to 77.8) 9732 7675 78.9 (78 to 79.7) -1.8 (-2.9 to -0.7)
>= Dose 3 11318 10487 92.7 (92.2 to 93.1) 9732 9109 93.6 (93.1 to 94.1) -0.9 (-1.6 to -0.3)

Table 4.2. Missing birth dose

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

Missing Vaccine Dose
Dose 2019 2020 Difference
Total Missing vaccine1 95% CI Total Missing vaccine1 95% CI Difference
HepB 11318 215 1.9 (1.7 to 2.2) 9732 165 1.7 (1.4 to 2) 0.2 (-0.2 to 0.6)
1 Total number of children who do not register the vaccine dose at any age

5. 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 5.1.

Children who take the 1st dose before 24 months.

Varicella (VAR)
Vaccine/Dose Total_year1 Success_year1 2019 Total_year2 Success_year2 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
VAR (>=Dose1) 11318 10385 91.8 (91.2 to 92.3) 9732 9056 93.1 (92.5 to 93.6) -1.3 (-2 to -0.6)

Table 5.2.

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

Missing Vaccine Dose
Dose 2019 2020 Difference
Total Missing vaccine1 95% CI Total Missing vaccine1 95% CI Difference
VRC 11318 746 6.59 (6.1 to 7.1) 9732 555 5.7 (5.3 to 6.2) 0.9 (0.2 to 1.5)
1 Total number of children who do not register the vaccine dose at any age

6. Pneumococcal conjugate (PCV)


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

Variables

  1. DPCV1: Age in days of prov-reptd pneumococal-containing shot #1.
  2. PCV1_AGE: Age in months of prov-reptd pneumococcal shot #1-9

Table 6.1.

Children who take the 4th dose before 24 months.

Pneumococcal (PCV)
Vaccine/Dose Total_year1 Success_year1 2019 Total_year2 Success_year2 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
PCV (>=Dose4) 11318 9678 85.5 (84.8 to 86.2) 9732 8397 86.3 (85.6 to 87) -0.8 (-1.7 to 0.2)

Table 6.2.

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

Missing Vaccine Dose
Dose 2019 2020 Difference
Total Missing vaccine1 95% CI Total Missing vaccine1 95% CI Difference
PCV 11318 339 3 (2.7 to 3.3) 9732 238 2.45 (2.1 to 2.8) 0.5 (0.1 to 1)
1 Total number of children who do not register the vaccine dose at any age

7. 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.

Table 7.1.

Children who take the 4th dose before 24 months.

Hepatitis A (HepA)
Vaccine/Dose Total_year1 Success_year1 2019 Total_year2 Success_year2 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
>=Dose1 11318 10037 88.7 (88.1 to 89.3) 9732 8774 90.2 (89.5 to 90.7) -1.5 (-2.3 to -0.6)
>=Dose 2 (by age 35 mos) 11318 10037 88.7 (88.1 to 89.3) 9732 8774 90.2 (89.5 to 90.7) -1.5 (-2.3 to -0.6)

Table 7.2.

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

Missing Vaccine Dose
Dose 2019 2020 Difference
Total Missing vaccine1 95% CI Total Missing vaccine1 95% CI Difference
HepA 11318 1052 9.29 (8.8 to 9.8) 9732 767 7.88 (7.4 to 8.4) 1.4 (0.7 to 2.2)
1 Total number of children who do not register the vaccine dose at any age

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.

SUMMARY.

Description 2019 % 2020 %
Total Children 33799 100 36750 100.0
Verified Info 16398 48.5 19456 52.9
Age 24-35 11318 33.5 13895 37.8
After remove dup ID 9732 26.5

Table 1

Estimated vaccination coverage by age 24 months according to the National Immunization Survey-Child, United States, 2019–2020

Summary
Vaccine/Dose 2019 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
Rotavirus (by age 8 mos) 79.1 (78.3 to 79.8) 79.5 (78.6 to 80.3) -0.4 (-1.5 to 0.7)
IPV >=Dose 3 93.8 (93.3 to 94.2) 94.6 (94.2 to 95.1) -0.8 (-1.5 to -0.2)
MMR (>=Dose 1) 92.8 (92.4 to 93.3) 94.4 (93.9 to 94.8) -1.6 (-2.2 to -0.9)
HepB
Birth dose 77.1 (76.3 to 77.8) 78.9 (78 to 79.7) -1.8 (-2.9 to -0.7)
>= Dose 3 92.7 (92.2 to 93.1) 93.6 (93.1 to 94.1) -0.9 (-1.6 to -0.3)
VAR (>=Dose1) 91.8 (91.2 to 92.3) 93.1 (92.5 to 93.6) -1.3 (-2 to -0.6)
PCV (>=Dose4) 85.5 (84.8 to 86.2) 86.3 (85.6 to 87) -0.8 (-1.7 to 0.2)
HepA
>=Dose1 88.7 (88.1 to 89.3) 90.2 (89.5 to 90.7) -1.5 (-2.3 to -0.6)
>=Dose 2 (by age 35 mos) 88.7 (88.1 to 89.3) 90.2 (89.5 to 90.7) -1.5 (-2.3 to -0.6)

Table 2. Missing vaccine

Children who do not register any dose of the respective vaccine.

Missing Vaccination
Vaccine/Dose 2019 2020 Difference
% (95% CI) % (95% CI) % (95% CI)
ROT 9.47 (8.9 to 10) 8.04 (7.5 to 8.6) 1.4 (0.7 to 2.2)
IPV 2.96 (2.7 to 3.3) 2.29 (2 to 2.6) 0.7 (0.2 to 1.1)
MMR 5.72 (5.3 to 6.2) 4.68 (4.3 to 5.1) 1 (0.4 to 1.6)
HepB 1.9 (1.7 to 2.2) 1.7 (1.4 to 2) 0.2 (-0.2 to 0.6)
VAR 6.59 (6.1 to 7.1) 5.7 (5.3 to 6.2) 0.9 (0.2 to 1.5)
PCV 3 (2.7 to 3.3) 2.45 (2.1 to 2.8) 0.5 (0.1 to 1)
HepA 9.29 (8.8 to 9.8) 7.88 (7.4 to 8.4) 1.4 (0.7 to 2.2)

Table 3. Children without any vaccine

Missing Vaccine
Race 2019 2020 Difference
Total Missing vaccine1 95% CI Total Missing vaccine1 95% CI Difference
All 11318 111 0.9807 (0.8075 to 1.1799) 9732 83 0.8529 (0.6799 to 1.0562) 0.1278 (-0.1297 to 0.3854)
Hispanic 2415 25 1.0352 (0.671 to 1.5244) 1989 17 0.8547 (0.4987 to 1.3649) 0.1805 (-0.391 to 0.752)
White 6734 57 0.8465(0.6417 to 1.0953) 5714 44 0.77 (0.5601 to 1.0324) 0.0765 (-0.2386 to 0.3914)
Black 771 7 0.9079 (0.3658 to 1.8617) 690 9 1.3043 (0.5981 to 2.4616) -0.3964 (-1.4758 to 0.6829)
Other 1398 22 1.5737 (0.9888 to 2.3729) 1339 13 0.9709 (0.5179 to 1.6545) 0.6028 (-0.2347 to 1.4403)
1 Total number of children who do not register the vaccine dose at any age

Missing vaccination Maps

Children without any vaccine.

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