August 20, 2003

Focus Area 14:Immunization and

Infectious Diseases Progress Review

Immunization and Infectious Disease Objectives

Immunization objectives

14-23 Vaccination in day care, grades K and 114-24 Fully immunized children

Plus others on

Disease prevalence Children and vaccinationProvider practice Immunization registriesHigh-risk adults Adverse eventsVaccine safety

Immunization and Infectious Disease ObjectivesInfectious Disease objectives

14-10 Identification of persons with chronic Hepatitis C.14-15 Prevention services for International travelers.

Plus others on

Hepatitis A, B, and C Bacterial meningitisPeptic ulcer hospitalizations Pneumococcal infections

Antibiotics use Meningococcal disease Hospital-acquired infections Lyme disease Anti-microbial use in ICU’s Group B streptococcal disease

.

Immunization and Infectious Disease Objectives

Tuberculosis objectives

TuberculosisCurative therapy for tuberculosis

Treatment for high-risk personsTimely laboratory confirmation

Morbidity Profile

Disease

Average prevalence

20th Cent. cases

2000 cases

Target

Measles 503,282 37 0

Diphtheria 175,885 1 0

Mumps 152,209 238 0

Pertussis 147,271 8,296 2,000

Rubella 47,745 14 0

H. Influenzae, type b 20,000 167 0

Polio (paralytic) 16,316 0 0

Tetanus 1,314 22 0

Congenital Rubella Syndrome 823 3 0

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+)

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), CDC, Division of Immunization, 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

Vaccine-specific coverage rates among pre-school aged children

Percent

405060708090

100

Hib (3+)

White, Not Hispanic

Black, Not Hispanic

Hispanic

American Indian / Alaskan Native

405060708090

100

Varicella (1+)

405060708090

100

MMR (1+)

405060708090

100

HepB (3+)

Asian

Universally Recommended Vaccination Coverage Among Children 19-35

Months, 2002

I 95% Confidence interval. § Data are statistically unreliable.Source: NIS, CDC, NIP and NCHS.

Percent Percent

Percent Percent

2010 Target

Native Hawaiian/ Other Pacific Islander Multiple Race

Obj. 14-22

§

§

§

White, Not Hispanic

Black, Not Hispanic

Hispanic

American Indian / Alaskan Native

405060708090

100

405060708090

100

405060708090

100

Asian

‡ Developmental objective. Target has not been determined.I 95% Confidence interval. § Data are statistically unreliable.Source: NIS, CDC, NIP and NCHS.

Universally Recommended Vaccination Coverage Among Children 19-35

Months, 2002

0

20

40

60

80

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

Obj. 14-22

§

§

§

§ § §

(2001)(2002)

0

10

20

30

40

50

60

70

80

90

Note: Percent receiving vaccine is estimated per Influenza season, using the January-June interviews only. Source: NHIS, CDC, NCHS.

2010 Target

Influenza Vaccination Coverage During the Past 12 Months, Among Adults 65

Years and Older

Percent

1988 1990 1992 1994 1996 1998 2000

Obj. 14-29a

2002

0102030405060708090

100

1998 1999 2000 2001 2002† Data are preliminary.

Source: NHIS, CDC, NCHS.

White

African American

Hispanic

2010 Target

Asian

Total

Pneumococcal Vaccination Coverage Ever Received Among Adults 65 Years

and OlderPercent

Obj. 14-29b

†

0

4

8

12

16

20

Hepatitis A Incidence

1999 ACIP recommendations

1996 ACIP recommendations

1995 vaccine licensure

† 2002 Data are preliminary.Source: NNDSS, CDC, EPO.

Cases per 100,000

1980 1985 1990 1995 2000

2010 Target

Obj. 14-6

2002

0

4

8

12

16

20

Hepatitis A Incidence

1999 ACIP recommendations

1996 ACIP recommendations

1995 vaccine licensure

† 2002 Data are preliminary.Source: NNDSS, CDC, EPO.

Cases per 100,000

1980 1985 1990 1995 2000

2010 Target

Obj. 14-6

2002

19 years and older

Less than 19 years old

Hepatitis B Incidence

0

5

10

15

20

25

30

35

40

45

50

Source: NNDSS, CDC, EPO.

Estimated cases per 100,000

19-39 years

40 years and older

Less than19 years

Obj. 14-3

1990 200220001998199619941992

1991 ACIP recommendations(for infant vaccination schedule)

Hepatitis B Incidence

1

10

100

Source: NNDSS, CDC, EPO.

Estimated cases per 100,000 (log-scale)

19-39 years

40 years and olderLess than19 years

Obj. 14-3

1990 200220001998199619941992

0

5

10

15

20

25

Hepatitis B Incidence, 2001

American Indian/ Alaska Native

I 95% Confidence interval.Source: 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

Obj. 14-3

0

5

10

15

20

25

30

35

402010 target

Rates of Tuberculosis

Note: Data in parentheses represent the percent change in the rates between 1998 and 2001Source: NTBSS, CDC, NCHSTP.

20011998

American Indian or

Alaska Native

Asian or Pacific Islander

Black, Not Hispanic

White, Not Hispanic

HispanicTOTAL

Obj. 14-11

10000

14000

18000

22000

26000

83 85 87 89 91 93 95 97 99 2001

Per 100,000 population

(-15%)

(-11%)

(-12%)

(-13%)

(-20%)

(-26%)

0

20

40

60

80

100Percent 2010 target

Proportion of Tuberculosis Patients Completing Curative

Therapy

Source: NTBSS, CDC, NCHSTP.

19991996

American Indian or

Alaska Native

Asian or Pacific Islander

Black, Not Hispanic

White, Not Hispanic

HispanicTOTAL

Obj. 14-12

Progress Review data and slides can be found on the

web at:

http://www.cdc.gov/nchs/hphome.htm