Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1167-1175 (doi:10.1542/peds.2006-0831)
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ARTICLE

Influenza Vaccination Coverage of Children Aged 6 to 23 Months: The 2002–2003 and 2003–2004 Influenza Seasons

Tammy A. Santibanez, PhD, Jeanne M. Santoli, MD, MPH, Carolyn B. Bridges, MD and Gary L. Euler, DrPH

National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia

BACKGROUND. Beginning in 2002 the Advisory Committee on Immunization Practices encouraged, when feasible, annual influenza vaccination of all children aged 6 to 23 months and household contacts and out-of-home caregivers of children <2 years of age.

OBJECTIVE. We sought to report influenza vaccination coverage for the 2002–2003 and 2003–2004 influenza seasons among children aged 6 to 23 months according to demographic and immunization-provider characteristics.

METHODS. Data from the 2003 and 2004 National Immunization Survey were analyzed. Two measures of childhood influenza vaccination are reported: receipt of ≥1 influenza vaccination and full vaccination (ie, receipt of the appropriate number of doses on the basis of previous vaccination history). {chi}2 tests and logistic-regression analyses to test for associations between influenza vaccination status and demographic characteristics were performed.

RESULTS. In the 2002–2003 and 2003–2004 influenza seasons only 7.4% and 17.5%, respectively, of children aged 6 to 23 months received ≥1 influenza vaccination, whereas only 4.4% and 8.4%, respectively, were fully vaccinated. In both seasons, adjusted influenza vaccination coverage was significantly lower among children living below the poverty level; non-Hispanic black children; older children; children with less-educated mothers; children vaccinated only at public clinics; and children not residing in a metropolitan statistical area.

CONCLUSIONS. During the first 2 years of the Advisory Committee on Immunization Practices' encouragement for children aged 6 to 23 months to receive influenza vaccination, coverage was low, with significant demographic differences in receipt of vaccination. Beginning with the 2004–2005 influenza season, they replaced the encouragement with a recommendation that children aged 6 to 23 months receive annual influenza vaccination. Substantial work remains to fully and equitably implement this new recommendation and ensure vaccination with 2 doses for previously unvaccinated children.

Key Words: influenza • influenza vaccination • vaccination coverage

Abbreviations: ACIP—Advisory Committee on Immunization Practices • NIS—National Immunization Survey • UTD—up-to-date • 4:3:1:3:3—≥4 doses of diphtheria and tetanus toxoids and pertussis vaccine, ≥3 doses of poliovirus vaccine, ≥1 dose of any measles-containing vaccine, ≥3 doses of Haemophilus influenzae type b vaccine, and ≥3 doses of hepatitis B vaccine • MSA—metropolitan statistical area • CI—confidence interval • OR—odds ratio • VFC—Vaccines for Children • BRFSS—Behavioral Risk Factor Surveillance System

Accepted Jun 13, 2006.




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