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State of Alaska

Health Indicator Report of Immunizations - 4:3:1:3:3:1:4 - Children (19-35 months) (HA2020 Leading Health Indicator: 17)

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.^2^ 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 doses of Haemophilis Influenza, type B (Hib), 1 dose of Varicella vaccine, and 4 doses of Pneumococcal conjugate vaccine (PCV). This recommendation is referred to in shorthand as "4:3:1:3:3:1:4." Children before the age of 2 can be protected from 14 vaccine-preventable diseases:^3^ * [https://www.cdc.gov/vaccines/parents/diseases/child/varicella.html Chickenpox (Varicella)] * [https://www.cdc.gov/vaccines/parents/diseases/child/diphtheria.html Diphtheria] * [https://www.cdc.gov/vaccines/parents/diseases/child/flu.html Flu (Influenza)] * [https://www.cdc.gov/vaccines/parents/diseases/child/hepa.html Hepatitis A] * [https://www.cdc.gov/vaccines/parents/diseases/child/hepb.html Hepatitis B] * [https://www.cdc.gov/vaccines/parents/diseases/child/hib.html Hib] * [https://www.cdc.gov/vaccines/parents/diseases/child/measles.html Measles] * [https://www.cdc.gov/vaccines/parents/diseases/child/mumps.html Mumps] * [https://www.cdc.gov/vaccines/parents/diseases/child/polio.html Polio] * [https://www.cdc.gov/vaccines/parents/diseases/child/pneumo.html Pneumococcal] * [https://www.cdc.gov/vaccines/parents/diseases/child/rotavirus.html Rotavirus] * [https://www.cdc.gov/vaccines/parents/diseases/child/rubella.html Rubella] * [https://www.cdc.gov/vaccines/parents/diseases/child/tetanus.html Tetanus] * [https://www.cdc.gov/vaccines/parents/diseases/child/pertussis.html Whooping Cough (Pertussis)] Vaccine-preventable diseases have a costly impact, resulting in doctor's visits, hospitalizations, and premature deaths; sick children can also cause parents to lose time from work.^4^ Thanks to immunizations, many once-common debilitating or fatal diseases like polio are now only distant memories for most Alaskans. Vaccines are a vital part of public health as they help protect not only the people who receive them, but also the people around them. [[br]] [[br]] ---- {{class .SmallerFont 2. U.S. Centers for Disease Control and Prevention (CDC). Ten great public health achievements in the 20th century. [http://www.cdc.gov/about/history/tengpha.htm]. Accessed October 7, 2016. 3. U.S. Centers for Disease Control and Prevention (CDC). For parents of infants and young children (birth through six years old). [https://www.cdc.gov/vaccines/parents/diseases/child/index.html] Accessed October 7, 2016. 4. U.S. Centers for Disease Control and Prevention (CDC). Benefits from immunization during the Vaccines for Children program era -- United States, 1994-2013. Morbidity and Mortality Weekly Report (MMWR) 2014;63(16);352-5.}}

Notes

Alaska Native is defined as American Indian or Alaska Native only, non-Hispanic on the NIS. ChildVaxView Interactive [https://www.cdc.gov/vaccines/imz-managers/coverage/childvaxview/data-reports/index.html] provides a simple user interface. Data from 2013 onward are from the Childhood Combined 7-vaccine Series Coverage [https://www.cdc.gov/vaccines/imz-managers/coverage/childvaxview/data-reports/7-series/index.html].

Data Sources

  • National Immunization Survey, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention
  • National Immunization Program, Indian Health Service

Data Interpretation Issues

The National Immunization Survey is one of a group of phone surveys used to monitor vaccination coverage among children 19-35 months, teens 13-17 years, and flu vaccinations for children 6 months-17 years.^1^ The surveys are sponsored and conducted by the National Center for Immunization and Respiratory Diseases (NCIRD) of the Centers for Disease Control and Prevention (CDC) and authorized by the Public Health Service Act [Sections 306]. The NIS was the first of the National Immunization Surveys, launched in 1994. The target population for the NIS is children who are or will be 19-35 months within a few weeks of being selected to participate in the survey and living in the United States. Data are used to monitor vaccination coverage among 2-year-old children at the national, state, selected local levels, and some in U.S. territories. The NIS measures coverage of the following recommended vaccinations: -Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP/DT/DTP) -Poliovirus vaccine (Polio) -Measles or Measles-Mumps-Rubella vaccine (MMR) -Haemophilus influenzae type b vaccine (Hib) -Hepatitis B vaccine (HepB) -Varicella zoster (chickenpox) vaccine (VAR) -Pneumococcal conjugate vaccine (PCV) -Rotavirus vaccine (ROT) -Hepatitis A vaccine (HepA) -Influenza vaccine (Flu). NIS collects data in two parts: 1. A household telephone survey. This survey is answered by parents and guardians, includes questions about vaccinations for their children 19-35 months, and asks permission to contact vaccination providers. 2. A mail survey of vaccination providers called the Immunization History Questionnaire. This survey is sent to doctors and other vaccination providers when a parent or guardian gives permission to collect data from vaccination providers. The Immunization History Questionnaire includes a reporting form for the types of vaccinations received, the number of doses, and the dates of administration.[[br]][[br]] ---- See Resources and References.

Definition

The percentage of children aged 19-35 months who reported receiving the recommended vaccines (4 DTaP, 3 Polio, 1 MMR, 3 Hep B, 3 Hib, 1 Varicella, 4 PCV) on the [http://www.cdc.gov/vaccines/imz-managers/nis/about.html National Immunization Survey (NIS)].

Numerator

Number of children aged 19-35 months who reported receiving at least 4 doses of DTaP, 3 doses of Polio, 1 dose of MMR, 3 doses of Hep B, 3 doses of Hib, 1 dose of Varicella antigens, and 4 doses of Pneumococcal conjugate vaccine on the NIS.

Denominator

Sample of children aged 19-35 months on the NIS.

Healthy People Objective: Achieve and maintain effective vaccination coverage levels for universally recommended vaccines among young children

U.S. Target: Not applicable, see subobjectives in this category
State Target: Healthy Alaskans 2020 Target: 75%

How Are We Doing?

In 2015, 66.3% of Alaska children 19-35 months received the recommended combined vaccine series. This level is below the 75.0% goal established by Healthy Alaskans 2020. Higher immunization rates are reported for Alaska Native children than all Alaskan children.

How Do We Compare With the U.S.?

In 2015, the national immunization rate for the recommended combined vaccine series for children 19-35 months was 72.2%. In comparison, the vaccination rate for Alaska children 19-35 months was 66.3%, an 8% reduction from the national rate.

What Is Being Done?

The mission of the Immunization Program is to prevent and control vaccine preventable disease in Alaska by^4^: * Providing vaccines to health care providers at no charge; * Providing an immunization information system for use by health care providers and schools to maintain consolidated immunization records for Alaskans of all ages; * Ensuring school and childcare compliance with immunization regulations; * Providing immunization education and training for health care providers and the general public; * Coordinating surveillance and control efforts for vaccine preventable diseases; and, * Supporting efforts to increase vaccinations for all Alaskans.[[br]] [[br]] ---- {{class .SmallerFont 5. Alaska Department of Health and Social Services. Immunization Program. [http://dhss.alaska.gov/dph/Epi/iz/Pages/default.aspx]. Accessed October 7, 2016. }}

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaska subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs. '''Strategy 1:''' [[br]]Enhance provider recall and reminder systems to review and update children's immunization status. '''Evidence Base:''' [[br]]The Community Guide provides evidence-based recommendations for preventive care and increasing appropriate vaccination. Client reminder and recall systems have been shown to improve vaccination coverage in both children and adults in a range of settings and populations. '''Source:''' [[br]][http://www.thecommunityguide.org/vaccines/healthsysteminterventions.html The Community Guide] '''Strategy 2:''' [[br]]Expand access to vaccines. '''Evidence Base:''' [[br]]Strongly recommended strategies include reducing out-of-pocket expenses and expanding access to health care services and vaccination programs in WIC settings. Nine states have developed private-public partnerships to provide universal vaccine purchase, which have reduced out-of-pocket expenses for providers and clients and increased 19-35 month old immunization rates among these states. '''Source:''' [[br]][http://www.thecommunityguide.org/vaccines/index.html The Community Guide] A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_17_Vaccinations.pdf].
Page Content Updated On 12/16/2016, Published on 12/16/2016
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 23 July 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Tue, 20 Dec 2016 07:58:39 AKST
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Mon, 23 July 2018 5:14:42 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Tue, 20 Dec 2016 07:58:39 AKST