Vaccine coverage rates high as VFC program celebrates 20 years

Coverage rates for routinely recommended vaccines for young children remain at or above the goals set by the Healthy People 2020 initiative, according to the CDC.

Much of this success is because of the Vaccines for Children program, which celebrates 20 years in existence this fall.

“We have come a long way in the 20 years since the VFC program was established,” Anne Schuchat, MD, MPH, director of the CDC’s National Center for Immunization and Respiratory Diseases, said during a media telebriefing today. “But there is still work to do.”

Schuchat said the origins of the VFC program compared with the current high immunization coverage rates and local hot spots “tell a story of striking contrast,” adding that the percentage of children in 2012 who did not receive any vaccinations remained at 0.8%.

When the VFC program was developed, it was designed to fix a national crisis of missed opportunities, she said. “Today we have a strong public-private partnership for immunizing children that reflects the success of the VFC program,” Schuchat said. “But today we also have local measles outbreaks that represent a very different dynamic. Instead of our system missing opportunities to vaccinate young children, in some communities, people have been rejecting opportunities to be vaccinated.”

Impressive coverage rates

The good news is that the 2012 National Immunization Survey (NIS) results indicate that vaccination coverage among children aged 19 to 35 months continues to be near or above the Healthy People 2020 target, defined as 90% for measles-mumps-rubella, poliovirus, hepatitis B (HepB), varicella, diphtheria-tetanus-acellular pertussis, pneumococcal conjugate vaccine and Haemophilus influenzae type b vaccines.

The childhood vaccination coverage remains near or above target levels for three or more doses of poliovirus vaccine (92.8%); at least one dose of MMR (90.8%); at least one dose of varicella vaccine (90.2%); and three or more doses of HepB (89.7%), according to this week’s Morbidity and Mortality Weekly Report.

Coverage rates for 2013 that remained steady with 2011 rates included the complete series of Hib (80.9%); rotavirus vaccine (68.6%); and two or more doses of hepatitis A vaccine (53%). However, coverage with four or more doses of PCV decreased from 84.4% in 2011 to 81.9% in 2012.

The small but statistically significant decrease in the 2012 rates with some vaccine compared with 2011 is likely a result of a change in NIS evaluation methods. The number of interviews conducted via mobile telephone increased in 2012 compared with 2011. Approximately half of the 2012 NIS unweighted sample came from the mobile telephone sampling frame compared with 11% of the 2011 unweighted sample.

In addition, the CDC reported that after a sustained increase from 2009 to 2011, likely attributable to recovery from a shortage of Hib vaccine from December 2007 to June 2009, coverage with the full series of Hib vaccine reached levels in 2012 similar to those of DTaP and PCV. Coverage with HepA and rotavirus also remained similar in 2012 compared with 2011, after several years of continued increase.

Methods for improvement

Although disparities in coverage were not observed for most racial/ethnic groups, according to the CDC report, children living in families with incomes below the federal poverty level had lower coverage than children living in families at or above the poverty level for at least four doses of DTaP vaccine; at least four doses of PCV vaccine; the full Hib series; at least two doses of hepatitis A vaccine; and rotavirus vaccine.

The CDC recommended that parents and health care providers work to sustain high coverage and improve coverage for the more recently recommended vaccines and those that require booster doses. Besides health system-based interventions, the agency recommends that providers should continue to partner with national, state and local immunization programs to implement the Guide to Community Preventive Services, which includes recommended interventions aimed at increasing community demand for vaccination, such as client reminder/recall and client or family incentives.

“We need to do a better job with vaccine doses needed in second year of life,” Schuchat said. “This continues to be important for us to focus on.”

Click here for more information on the Healthy People 2020 goals. – by Cassandra A. Richards

Disclosure: Schuchat reports no relevant financial disclosures.