The addition of new vaccines (e.g., varicella vaccine) to the existing
vaccination schedule presents a challenge to the vaccine-delivery system that
must be met before the full benefits of new vaccine technology can be realized.
The achievement of the 1996 goals during July 1996-June 1997 was a major milestone
in the effort to control vaccine-preventable diseases; however, this reporting
period indicated only one net gain compared with 1996: a modest increase in
hepatitis B vaccine coverage. Furthermore, except for varicella vaccine, no
other meaningful increases were detected for the last quarter of this reporting
period, which may suggest a leveling off in vaccination coverage. To overcome
this apparent leveling in coverage, and to attain the year 2000 objective
of 90% coverage with a complete series, vaccination providers must become
even more efficient and effective in ensuring full protection of children.
Each day, an estimated 11,000 children are born in the United States, and
all must receive 12-16 doses of vaccine before the second birthday to be fully
vaccinated. Achievement of the 1996 goals demonstrates that reaching high
coverage levels is possible but does not ensure such coverage in the future.
Meeting these and other goals at the national, state, and local levels requires
a fully functional vaccination delivery system, which remains incomplete in
1998. Important components of this system are state- and community-based computerized
vaccination registries, which include all children from birth and can identify
children in need of vaccines and recall them for missed vaccinations8; ongoing quality assurance and information feedback
activities; continuous education programs for parents and health-care providers,
which remain to be fully created and implemented9;
and expanding and strengthening the links to the Special Supplemental Nutrition
Program for Women, Infants, and Children.10
CDC will continue to use NIS to monitor and target efforts to improve vaccination
coverage levels in the United States.