Important Facts for Immunizations: 4:3:1:3:3:1:4
DefinitionChildren aged 19-35 months who received the recommended vaccines (4 DTaP, 3 Polio, 1 MMR, 3 Hep B, Hib full series, 1 Varicella, and 4 PCV).
NumeratorNumber of children aged 19-35 months that have received at least 4 doses of DTaP, 3 doses of Polio, 1 dose of MMR, 3 doses of Hep B, 3 or 4 doses of Hib (depending on product type), 1 dose of Varicella, and 4 Pneumococcal.
DenominatorChildren aged 19-35 months.
Data Interpretation IssuesThe National Immunization Survey (NIS) is conducted by the Centers for Disease Control and Prevention (CDC) and uses a random-digit-dialing sample of landline and cellular telephone numbers to find households throughout the U.S. with children aged 19 to 35 months. They ask parents or guardians to tell them the vaccines (with dates) that appear on the child's "shot card" kept in the home, and they also collect demographic and socioeconomic information. At the end of the interview, they ask for permission to contact the child's vaccination providers. Providers are then contacted by mail to verify each child's vaccinations. The NIS uses a nationally representative sample, and provides estimates of coverage that are weighted to represent the entire population, nationally, and by region, state, and selected large metro areas. The large sample size (approximately 15,000) allows them to stratify (that is, subdivide) the data so that they can examine vaccination rates among different groups, for instance by income level, race, education level of mothers, and other factors. In 2014, NIS analysis for the complete 4:3:1:3:3:1:4 series was updated to provide a more accurate assessment of ''Haemophilus influenzae'' type B (HIB) vaccination. Past surveys classified the minimum number of Hib doses necessary as complete even though certain brands required more doses; the 2014 survey took into account the Hib vaccine brand, if known, and classified a child as complete only if the appropriate number of doses had been administered. The 2014 results are more accurate and better match methods now used by the CDC. Due to this change, the 2014, 2015, and 2016 results for 4:3:1:3:3:1:4 coverage are not comparable to prior years.
Why Is This Important?Immunizations are the most cost-effective health prevention measures. Development of vaccinations had been cited by the U.S. Public Health Service as one of the Ten Great Public Health Achievements in the 20th Century^1^. Vaccines play an essential role in reducing and eliminating disease. By two years of age, it is recommended that all children should have received 4 doses of diphtheria-tetanus-pertussis (DTP), 3 doses of polio, 1 dose of measles-mumps-rubella (MMR), 3 doses of Hepatitis B, 3 or 4 doses of ''Haemophilus influenzae'' type B (Hib) (depending on product type received), 1 dose of Varicella, and 4 doses of pneumococcal vaccine. This recommendation is referred to in shorthand as "4:3:1:3:3:1:4." [[br]][[br]] ---- 1. Centers for Disease Control and Prevention. (1999). Achievements in Public Health, 1900-1999: Impact of vaccines universally recommended for children -- United States 1990-1998. ''Morbidity and Mortality Weekly Report,'' Vol. 48, (12);243-248. Atlanta, GA: author.
Healthy People Objective IID-7:Achieve and maintain effective vaccination coverage levels for universally recommended vaccines among young children
U.S. Target: Not applicable, see subobjectives in this category