tively low vaccine utilization. Because of the association of appropriate health care with an individual’s economic status, race, and gender, access to immunization coverage proves difficult for many racial and ethnic minorities. For example, although rubella has been virtually eliminated within the U.S.-born population, rubella outbreaks have occurred sporadically among Hispanic populations in the last 5 years as a result of immigration from countries where rubella vaccine is not part of the childhood immunization schedule (information provided by CDC).

Finding 2–4. Important strides have been made in decreasing the incidence of vaccine-preventable diseases and increasing the immunization coverage levels for children and adults. However, sustained efforts are needed to address the troublesome disparities that remain in childhood and adult coverage levels.



The harmonized schedule is determined jointly by the American Academy of Pediatrics (AAP), the Advisory Committee on Immunization Practices (ACIP), and the American Academy of Family Physicians (AAFP).


For example, researchers are experimenting with a measles, mumps, rubella, varicella (MMRV) vaccine that will include four distinct antigens in one injection (S.Katz, Duke University, personal communication, 1999).


“Other” includes community health centers, the military, hospital-based clinics, and those who describe themselves as “other.”

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