TABLE 2 Estimated Vaccination Coverage for the 4:3:1:3* Series Among Children Ages 19 to 35 Months, United States and California, 1996–2000

 

Percent

Area

1996

1997

1998

1999

2000

United States

76

76

79

78

76

California

74

74

76

75

75

City of Los Angeles

75

72

76

76

76

San Diego County

74

78

77

75

76

City of Santa Clara

80

69

84

82

76

Rest of state

72

76

75

74

75

*Four or more doses of DTP, three or more doses of poliovirus vaccine, one or more doses of any measles-containing vaccine, and three or more doses of Hib vaccine

SOURCES: CDC, National Immunization Survey (www.cdc.gov/nip/coverage).

state also purchases 700,000 doses of influenza vaccine for use by county health departments to help assure the delivery of immunization services to the high-risk population. Dr. Smith noted, however, that the cost of influenza vaccine had more than doubled in a single year, going from $1.80 per dose in 1999 to $4.45 per dose for 2000.

As part of its surveillance activities, the state monitors both immunization coverage rates and immunization exemptions granted for personal beliefs. Immunization rates for 2-year-olds in California are comparable to rates for the nation as a whole (see Table 2 and www.cdc.gov/nip/coverage). The latest data for 2000 from the National Immunization Survey (NIS) show that 75 percent of California’s 2-year-olds are fully immunized for the 4:3:1:3 series, compared with the national average of 74 percent. Preliminary estimates for the 2001–2002 school year indicate that about 1.2 percent of children entering kindergarten were not immunized because of exemptions for their families’ personal beliefs. In some counties, up to 5 percent of children have been exempted. Where exemption rates are high, the state health department is concerned about increased risk for disease outbreaks.

The immunization rates for older adults (ages 65 and over) exceed the national average but still fall short of the national public health goal of 90 percent coverage. Dr. Smith reported that California data for 2000 show that 70 percent of older adults reported having received an influenza vaccination in the previous year. The national rate for 1999 was 67 per



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