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Healthy People 2010 Immunization and Infectious Disease Objectives Infectious Disease objectives 14-2Chronic Hepatitis B virus infections in infants and young children 14-3Hepatitis B infections 14-4Bacterial meningitis in young children 14-5 Invasive pneumococcal infections 14-6Hepatitis A 14-7Meningococcal disease 14-8Lyme disease 14-9Hepatitis C 14-10Chronic Hepatitis C infection identified by state and local health departments 14-15International travelers who receive preventive services 14-16Invasive early onset group B strep disease 14-17Hospitalizations caused by peptic ulcer disease 14-18Course of antibiotics for ear infections for young children 14-19Courses of antibiotics prescribed for sole diagnosis of common cold 14-20Hospital-acquired infections in intensive care unit patients 14-21Anti-microbial use among intensive care unit patients 14-28Hepatitis B vaccine coverage among high-risk groups
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August 20, 2003
Focus Area 14:Immunization and
Infectious Diseases Progress Review
Healthy People 2010 Immunization and Infectious
Disease ObjectivesImmunization objectives14-1 Cases of vaccine-preventable diseases.14-22 Vaccination coverage levels for universally recommended vaccines
among young children.14-23 Vaccination coverage levels for children in licensed day care
facilities and children in kindergarten through first grade.14-24 Proportion of young children who receive all vaccines that have
been recommended for universal administration for at least 5 years.
14-25 Proportion of providers who have measured the vaccination coverage level among children in their practice population within the past 2 years.
14-26 Proportion of children who participate in fully operational population-based registries.
14-27 Routine vaccination coverage levels of adolescents.14-29 Proportion vaccinated against influenza and pneumococcal disease14-30 Vaccine-associated adverse events14-31 Persons under surveillance for vaccine safety
Healthy People 2010 Immunization and Infectious
Disease ObjectivesInfectious Disease objectives14-2 Chronic Hepatitis B virus infections in infants and young children14-3 Hepatitis B infections14-4 Bacterial meningitis in young children14-5 Invasive pneumococcal infections14-6 Hepatitis A14-7 Meningococcal disease14-8 Lyme disease14-9 Hepatitis C14-10 Chronic Hepatitis C infection identified by state and local health departments14-15 International travelers who receive preventive services14-16 Invasive early onset group B strep disease14-17 Hospitalizations caused by peptic ulcer disease14-18 Course of antibiotics for ear infections for young children14-19 Courses of antibiotics prescribed for sole diagnosis of common cold14-20 Hospital-acquired infections in intensive care unit patients14-21 Anti-microbial use among intensive care unit patients14-28 Hepatitis B vaccine coverage among high-risk groups
Healthy People 2010 Immunization and Infectious
Disease ObjectivesTuberculosis objectives
14-11 Rates of Tuberculosis.14-12 Proportion of tuberculosis
patients completing curative therapy.14-13 Proportion of contacts and
other high-risk persons with latent tuberculosis infection completing curative therapy.
14-14 Average time for a laboratory to confirm and report tuberculosis cases.
20th CenturyAverage Annual Morbidity 2002†
2010 Target
Diphtheria
Measles
Mumps
Pertussis
Polio (paralytic)
Rubella
Congenital Rubella Syndrome
Tetanus
H. influenzae, type b and unknown (<5 yrs)
175,885
503,282
152,209
147,271
16,316
47,745
823
1,314
20,000‡
1
37
238
8,296
0
14
3
22
167
0
0
0
2,000
0
0
0
0
0
Source: CDC. MMWR 1999. 48: 242-264.
† Data are preliminary. ‡ Data are estimated.
Disease
Comparison of 20th Century Average Annual Morbidity and
2002 Morbidity, Vaccine-Preventable Diseases
Numbers in red indicate record lows in 2002
0
20
40
60
80
100
1967 1970 1973 1976 1979 1982 1985 1988 1991 1994 1997 2000
DTP(3+)†
MMR(1+) Polio (3+)
Hib (3+)
Hep B (3+)
Varicella (1+)
† DTP(3+) is not a Healthy People 2010 objective. DTP(4) is used to assess Healthy People 2010 objectives.Note: Children in the USIS and NHIS were 24-35 months of age. Children in the NIS were 19-35 months of age.Source: USIS (1967-1985), NHIS (1991-1993) CDC, NCHS, and NIS (1994-December 2002), CDC, NIP and NCHS; No data
from 1986-1990 due to cancellation of USIS because of budget reductions
2010 Target
14-22. Vaccine-specific coverage rates among pre-
school aged childrenPercent
0102030405060708090
100
1998 1999 2000 2001 2002
DTP
MMRPolio
Hib
Hep B
Varicella
Source: National Immunization Survey (NIS), CDC, NIP and NCHS.
2010 Target
14-22. Achieve and maintain effective vaccination coverage levels for
universally recommended vaccines
Percent of children 19-35 months
PCV
0
20
40
60
80
100
WhiteBlack
Measles vaccination coverage Measles vaccination coverage among among
preschool-aged children, by preschool-aged children, by racerace
Other
Note: Children in the USIS and NHIS were 24-35 months of age. Children in the NIS were 19-35 months of age.Source: 1970-1983 United States Immunological Survey (USIS), CDC, Division of Immunization, 1992-1993 National Health Interview Survey (NHIS), CDC, NCHS; 1994-2001 National Immunization Survey (NIS), CDC, EPO.
Percent
19831970 1976 1992 1994 2001
White, Not Hispanic
Black, Not Hispanic
Hispanic**
American Indian / Alaskan Native*
405060708090
100
Varicella (1+)
405060708090
100
MMR (1+)
405060708090
100
HepB (3+)
Asian*
I 95% Confidence interval. § Data are statistically unreliable.*Includes persons of Hispanic and non-Hispanic origin ** Can be of any race Source: National Immunization Survey (NIS), CDC, NIP and NCHS.
Percent Percent
Percent Percent
2010 Target
405060708090
100
Hib (3+)
Native Hawaiian/ Other Pacific Islander* Multiple Race*
Obj. 14-22
§
§§
14-22. Universally recommended vaccination coverage among children 19-35 months, by race and ethnicity,
2002
White, Not Hispanic
Black, Not Hispanic
Hispanic**
American Indian / Alaskan Native*
405060708090
100
405060708090
100
405060708090
100
Asian*
† DTP (3) is not a Healthy People 2010 objective. ‡ Developmental objective. Target has not been determined. * Includes persons of Hispanic and non-Hispanic origin ** Can be of any race I 95% Confidence interval.Source: National Immunization Survey (NIS), CDC, NIP and NCHS.
14-22. Universally recommended vaccination coverage among children 19-35 months, by race and ethnicity,
2002
020406080
100
DTP (4+) DTP (3+)
Percent Percent
Percent
4:3:1:3:3 Series
2010 Target
PCV(3+)‡
Percent
Native Hawaiian/ Other Pacific Islander* Multiple Race*
§
§
§
§ § §
70
75
80
85
90
95
1002010 target ‡
14-23. Vaccination coverage of children in daycare, kindergarten,
and first grade, 2002†
† Developmental Healthy People 2010 objective. ‡ Proposed Healthy People 2010 target.^ Kindergarten and first grade percentage based on data from 40 states and the District of Columbia. All states require 3 doses of HepB, however the District of Columbia requires 2 doses. ^ ^ Kindergarten and first grade percentage based on data from 24 states and the District of Columbia. Source: National Immunization Survey (NIS), CDC, NIP and NCHS; School Entry Immunization Assessment Report, CDC, NIP.
Kindergarten and first grade
DaycarePercent
Hepatitis B^ Varicella^^
HepB (3+) MMR (1+) DTaP (4)
14-27. Universally recommended vaccination coverage among children 13-
15 years, 2001
Source: National Health Interview Survey (NHIS), CDC, NCHS.
55%
74%
76%
93%
34
92%
55%
76%
34%
Shot-record data onlyShot record and recall data
2010 Target
0
20
40
60
80
100
1997 1998 1999 2000 2001
14-27a. 3 or more doses of Hepatitis B vaccination among adolescents 13-15
years
Source: National Health Interview Survey (NHIS), CDC, NCHS.
2010 Target
Shot record data only
Shot record and recall data
Percent
0
20
40
60
80
100
1997 1998 1999 2000 2001
14-27b. 1 or more doses of MMR vaccination among adolescents 13-15
years
Source: National Health Interview Survey (NHIS), CDC, NCHS.
2010 Target
Shot record data only
Shot record and recall data
Percent
0
20
40
60
80
100
1997 1998 1999 2000 2001
14-27c. 1 or more doses of Td vaccination among adolescents 13-15 years
Source: National Health Interview Survey (NHIS), CDC, NCHS.
2010 Target
Shot record data only
Shot record and recall data
Percent
80-89%70-79%60-69%
† 4+DTP, 3+Polio, 1MCV, 3+Hib, 3+HepB
79 76
82
75
80
77
72
76
78
78
75
68
63
69
67
65
7676
73
81VT 81
75
73
79
70
69
75
80
82
79
7277
79
69
77
73
78
78
80
71
67
65
68
NJCT
MANH
RI
DC
DEMD
8477858276798670
National Coverage = 75%
Source: National Immunization Survey (NIS), CDC, NIP and NCHS.
14-24a. Vaccination coverage with the 4:3:1:3:3† series, among children 19-35
months, 2002
0102030405060708090
Note: Percent receiving vaccine is estimated per Influenza season, using the January-June interviews only. Source: National Health Interview Survey (NHIS), CDC, NCHS.
2010 target
14-29a. Influenza vaccination coverage during the past 12 months,
among adults 65 years and olderPercent
1988 1990 1992 1994 1996 1998 2000 2002
0102030405060708090
1002010 target
* Can be of any race.
Source: National Health Interview Survey (NHIS), CDC, NCHS.
White, Not Hispanic
Hispanic *
Black, Not Hispanic
14-29a. Influenza vaccination coverage during the last 12 months
of adults 65 years and older, by race/ethnicity
Percent
1989 1991 1993 1995 19991997 2001
0102030405060708090
100
1998 1999 2000 2001 2002† Data are preliminary.* Includes persons of Hispanic and non-Hispanic origin. ** Can be any race.Source: National Health Interview Survey (NHIS), CDC, NCHS.
White
African American
Hispanic**
2010 Target
Asian*
Total
14-29b. Pneumococcal vaccination coverage ever received among adults 65 years and
older, by race/ethnicityPercent
†
0
10
20
30
40
50
60
1997 1998 1999 2000 2001
† High risk persons include respondents with one or more of the following conditions: heart disease, diabetes, asthma, chronic bronchitis, kidney disease, and cancer (excluding skin cancer).Source: National Health Interview Survey (NHIS), CDC, NCHS.
2010 Target
14-29c. Influenza vaccination in past 12 months among adults with high risk
conditions†, ages 18-64Percent
50-64 years of age
18-49 years of age
0
10
20
30
40
50
60
† High risk persons include respondents with one or more of the following conditions: heart disease, diabetes, asthma, chronic bronchitis, kidney disease, and cancer (excluding skin cancer).* Includes persons of Hispanic and non-Hispanic origin. ** Can be of any race. I 95% Confidence interval.Source: National Health Interview Survey (NHIS), CDC, NCHS.
2010 Target
14-29c. Influenza vaccine coverageamong adults with high risk conditions†,
ages 18-64, by race/ethnicity1998 2001
TOTAL White, Not Hispanic
Black, Not Hispanic
Hispanic ** Asian* American Indian or
Alaska Native*
Percent
0
10
20
30
40
50
60
1997 1998 1999 2000 2001† High risk persons include respondents with one or more of the following conditions: heart disease, diabetes, asthma, chronic bronchitis, kidney disease, and cancer (excluding skin cancer).Source: National Health Interview Survey (NHIS), CDC, NCHS.
2010 Target
14-29d. Pneumococcal vaccination ever received, among adults with high risk conditions†, ages 18-64
years
50-64 years old
18-49 years old
Percent
0
10
20
30
40
50
60
** Can be of any race.† High risk persons include respondents with one or more of the following conditions: heart disease, diabetes, asthma, chronic bronchitis, kidney disease, and cancer (excluding skin cancer).Source: National Health Interview Survey (NHIS), CDC, NCHS.
HP 2010 Target
14-29d. Pneumococcal vaccine ever received among adults with high risk
conditions†, 18- 64 years, by race/ethnicity
Percent 1998 2001
TOTAL White, Not Hispanic
Black, Not Hispanic
Hispanic**
14-6. Reduce Hepatitis A
0
2
4
6
8
10
12
1997 1998 1999 2000 2001 2002
Hepatitis A
2010 Target
Cases per 100,000
Source: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO.
Hepatitis A Incidence
0
4
8
12
16
1999 ACIP recommendations
1996 ACIP recommendations1995 vaccine licensure
† Data are preliminary.Source: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO.
Cases per 100,000
1980 1985 1990 1995 2000 2002†
2010 Target
14-6. Reduce Hepatitis A, by race and ethnicity
0
5
10
15
20
25
1997 1998 1999 2000 2001 2002
2010 Target
Cases per 100,000
* Not Hispanic ** Can be of any race AI/AN = American Indian Alaska Native A/PI= Asian or Pacific IslanderSource: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO.
Hispanic**
AI/ AN
A/PI
Black*White*
Hepatitis A Incidence, by age
02468
101214161820
Incidence per 100,000
† Data are preliminary.Source: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO.
19 years and older
Less than 19 years old
1990 1992 1994 1996 1998 2000 2002†
Hepatitis B Incidence
05
101520253035404550
† The number of hepatitis B cases reported to NNDSS by year of age is multiplied by age-specific ratios of infections to reported cases and by the age-specific proportions of infections which are symptomatic. Source: National Notifiable Diseases Surveillance System (NNDSS), CDC, EPO.
Estimated† cases per 100,000
19-39 years
40 years and older
Less than19 years
Obj. 14-3
1990 200220001998199619941992
0
5
10
15
20
25
14-3. Hepatitis B Incidence, by race and ethnicity, 2001
American Indian/ Alaska Native*
I 95% Confidence interval.*Includes persons of Hispanic and non-Hispanic origin **Can be of any race.Source: National Notifiable Diseases Surveillance System (NNDSS), CDC, EPO.
Per 100,000 2010 target
19-24 years 25-39 years 40 years and older
Asian or Pacific Islander*
Hispanic**
White, Not Hispanic
Black, Not Hispanic
14-11. Cases of Tuberculosis
10000120001400016000180002000022000240002600028000
83 85 87 89 91 93 95 97 99 20011982
1986 1990
1994
1998 2002†
† Data are preliminary
Number of Cases
Source: National TB Surveillance System, CDC, NCHSTP.
05
10152025303540
2010 target
14-11. Rates of Tuberculosis, by race and ethnicity
* Includes persons of Hispanic and non-Hispanic origin **Can be of any raceNote: Data are age adjusted to the 2000 standard population. Data in parentheses represent the percent change in the rate between 1998 and 2001.Source: National TB Surveillance System, CDC, NCHSTP.
20011998
American Indian or
Alaska Native*
Asian or Pacific Islander*
Black, Not Hispanic
White, Not Hispanic
Hispanic**TOTAL
Per 100,000 population
-15%-11%
-12%
-13%-20%
-26%
0
20
40
60
80
100Percent 2010 target
14-12. Proportion of Tuberculosis Patients
Completing Curative Therapy
* Includes persons of Hispanic and non-Hispanic origin **Can be of any raceSource: National TB Surveillance System, CDC, NCHSTP.
19991996
American Indian or
Alaska Native*
Asian or Pacific Islander*
Black, Not Hispanic
White, Not Hispanic
Hispanic**TOTAL
0
20
40
60
80
100
1991 1994 2002
Percent
Percent of Tuberculosis labs using recommended procedures
Source: Tuberculosis Elimination and Laboratory Upgrade Cooperative Agreements. Unpublished CDC data.
Rapid Drugs
Liquid Media
FluorochromeRapid I. D.
0
20
40
60
80
100
1991 1994 2002
Percent
Percent of Tuberculosis labs meeting turn-around time goal
Note: Data for laboratories using Liquid Media procedures was not available.Source: Tuberculosis Elimination and Laboratory Upgrade Cooperative Agreements. Unpublished CDC data.
FluorochromeRapid I. D.
Rapid Drugs
Developmental Objectives
14-10. Increase the proportion of persons with chronic Hepatitis C infection identified by State and local health departments.(proposed source, National Electronic Telecommunications System for Surveillance)
14-15. Increase the proportion of international travelers who receive recommended preventive services when traveling in areas of risk for: hepatitis A, malaria, and typhoid.(proposed source, Travelers’ Health Survey)
14-22g. Achieve and maintain the levels of pneumococcal conjugate vaccination coverage among young children. (future source, National Immunization Survey)
Developmental Objectives
14-23d, e. Maintain vaccination coverage levels for children in licensed day care facilities- Hepatitis B and Varicella.(proposed source, National Immunization Survey)
14-23i, j. Maintain vaccination coverage levels for children in kindergarten and first grade- Hepatitis B and Varicella.(proposed source, The School Entry Immunization Assessment Report)
14-24b. Increase the proportion of adolescents who receive all vaccines that have been recommended for universal administration for at least 5 years(proposed source, National Immunization Survey)
Progress Review data and slides can be found on the web at:
http://www.cdc.gov/nchs/hphome.htm
