2019 National Immunization Survey (NIS) - Vaccination Coverage Levels

National Immunization Survey-Child (NIS-Child) 2019, Texas

Immunization Coverage Among Texas Children at 24 Months of Age

Source: CDC NIS Child Report

About the National Immunization Survey (NIS)

The NIS-Child is a national survey conducted annually by the Centers for Disease Control and Prevention to assess immunization levels among pre-school children (at 2 years of age for most immunizations). The NIS is the only population-based survey to provide national, state, local area, and territorial estimates of vaccination coverage among children in the United States. This study collects data by administering telephone surveys to randomly selected households. To ensure the accuracy and precision of the vaccination coverage estimates, immunization data for surveyed children are also collected through a mail survey of their pediatricians, family physicians, and other health care providers. The parents and guardians of eligible children are asked during the telephone interview for consent to contact the children’s vaccination providers. Types of immunizations, dates of administration, and additional data about facility characteristics are requested from immunization providers that are identified during the telephone survey of households. Data are weighted to be representative of the population of children 24 months of age, and are adjusted for multiple phone lines, mixed telephone lines (i.e., landline and cellular), household nonresponse, and the exclusion of phoneless households.

The NIS provides national and state estimates of vaccination coverage, including new vaccines as they are licensed and recommended for use. The survey also tracks progress towards Healthy People 2020 goals.

CDC changed the way that NIS results are reported starting in 2019. In the past, results were reported for children 19-35 months of age at the time of the survey. Now, results for most vaccines are reported at 24 months of age, by birth year (i.e. coverage is reported among 2-year-olds born in 2015). Certain vaccines (Hepatitis B birth dose and Rotavirus) are reported at younger ages because they are completed before 24 months.

Survey Sample

The survey assessed the immunization histories of over 25,000 children in the United States born in 2016 and 2017. Coverage estimates for children born in 2016 are preliminary, because some had not yet reached 24 months of age at the time of the most recent survey.

Vaccines Included

The NIS collects information on the following vaccine series to assess the percent of children that are up to date with routinely recommended vaccinations:

  • Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP/DT/DTP)
  • Poliovirus vaccine (Polio)
  • Measles or Measles-Mumps-Rubella vaccine (MMR)
  • Haemophilus influenzae type b vaccine (Hib)
  • Hepatitis B vaccine (HepB)
  • Varicella vaccine (Var)
  • Pneumococcal conjugate vaccine (PCV)
  • Hepatitis A vaccine (HepA)
  • Rotavirus vaccine
  • Influenza (Flu)
  • 4:3:1:3*:3:1:4 series
    o   ≥4 doses of DTaP
    o   ≥3 doses of Polio
    o   ≥1 dose of MMR
    o   ≥3 doses of Hib (*3 or 4 doses depending on vaccine type)
    o   ≥3 doses of HepB
    o   ≥1 dose of Var
    o   ≥4 doses of PCV

The 4:3:1:3*:3:1:4 series reflects vaccine coverage for seven key vaccines combined. It measures overall compliance with the recommendations of the Advisory Committee on Immunization Practices (ACIP) for young children.

aCoverage estimates are at 24 months unless otherwise noted (i.e. rotavirus vaccine coverage assessed at 8 months)
bData for the 2014 birth year are from survey years 2015, 2016, and 2017; data for the 2015 birth year are from survey years 2016, 2017, and 2018; data for the 2016 birth year are from survey years 2017, 2018, and 2019; data for the 2017 birth year are considered preliminary and come from survey years 2018 and 2019 
cFull series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on vaccine type
Either ≥2 or ≥3 doses of rotavirus vaccine, depending on product used, by 8 months of age
Doses must be at least 24 days apart (four weeks, with a four-day grace period)
f 4:3:1:3:3:1:4 includes 4+ DTaP (diphtheria, tetanus, and acellular pertussis), 3+polio, 1+MMR (measles, mumps and rubella), 3 or 4 doses Hib, depending on vaccine type, 3+Hep B, 1+varicella, and 4+PCV
Statistically significant difference from zero (p<0.05)
Statistically significant difference from U.S estimate (p<0.05)



See accessible data table of chart below:

 NIS-Teen Immunization Coverage Estimates for the 4:3:1:3:3:1:4 Series by 24 Months of Age, for Children Born in 2016 and 2017             
  U.S. Texas Bexar County City of Houston  Dallas County  El Paso County  Hidalgo County  Tarrant County 
4:3:1:3:3:1:4 Coverage 70.5%    67.7%    72.6%    72.4%  56.7%  71.4%  70.8%  69% 

* Hidalgo and Tarrant Counties were sampled in 2018 only; all other areas of Texas were sampled in 2016, 2017, and 2018.