2020 National Immunization Survey Results

Table of Contents

National Immunization Survey-Child (NIS-Child) 2020, Texas

Immunization Coverage Among Texas Children At 24 Months Of Age

Source: CDC NIS-Child Report

About the National Immunization Survey-Child (NIS-Child)

The National Immunization Survey–Child (NIS-Child) is conducted annually by the Centers for Disease Control and Prevention (CDC) to assess immunization coverage (percent of the population vaccinated) among young children.

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. 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 survey also tracks progress toward Healthy People 2020 and Healthy People 2030 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. Exemptions to this are the hepatitis B birth dose and Rotavirus vaccines which are reported at younger ages because they are completed before 24 months.

Coverage rates were reported for the U.S., Texas, and the selected areas of the City of Houston, Bexar County, El Paso County, and Dallas County.

Survey Sample

2020 NIS-Child data was collected from 2018 to 2020, resulting in a national sample size of 29,114 children born in 2017-2018 with adequate provider data. Additionally, these estimates reflect vaccinations that occurred mostly before the COVID-19 pandemic. For data collected in 2020, there was a low interview response rate (22.5%) and adequate provider data was available for only 54.2% of those with completed interviews.

Vaccines Included

The NIS collects information on the following vaccine series to assess the percentage 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
    • ≥4 doses of DTaP
    • ≥3 doses of Polio
    • ≥1 dose of MMR
    • ≥3 doses of Hib (*3 or 4 doses depending on vaccine type)
    • ≥3 doses of HepB
    • ≥1 dose of Var
    • ≥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.

NIS-Child Immunization Coverage Estimates in Texas and the U.S. by 24 Monthsa, 2016-2020

Vaccine

U.S.
Children born
2017-2018b

Texas
Children born
2015-2016

Texas
Children born
-2018b

Texas Percentage point difference

≥4 doses diphtheria, tetanus, acellular pertussis (4+DTaP)

81.6%

79.1%

77.4%g

-1.7%

≥3 doses inactivated poliovirus (3+Polio)

92.7%

91.5%

90.6%

-0.9%

≥1 dose measles, mumps, rubella (1+MMR)

91.6%

89.9%

90.9%

1.0%

Haemophilus influenzae full series (Hib-FS)c

80.2%

78.6%

76.0%

-2.6%

1 dose Hepatitis B in first 3 days of life (Hep B Birth)

78.4%

79.4%

79.8%

0.4%

≥3 doses Hepatitis B (3+HepB)

91.9%

89.5%

88.0%g

-1.5%

≥1 dose varicella (1+VAR)

90.9%

89.2%

89.6%

0.4%

≥4 doses pneumococcal conjugate (4+PCV)

82.3%

80.8%

79.9%

-1.0%

≥ 1 dose Hepatitis A (1+HepA)

87.0%

88.8%

88.4%

-0.5%

Rotavirus series (Rota)d

75.6%

73.7%

74.3%

0.6%

≥2 doses influenza (2+Flu)e

60.6%

53.8%

52.6%g

-1.2%

7-vaccine series (4:3:1:3c:3:1:4)f

70.5%

66.8%

65.9%

-0.9%

aCoverage estimates are at 24 months unless otherwise noted (i.e. rotavirus vaccine coverage assessed at 8 months)

bData 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 from survey years 2018, 2019, and 2020; data for the 2018 birth year are considered preliminary and come from survey years 2019 and 2020 (data from the survey year 2021 are not yet available).

cFull series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on the vaccine type

d Either ≥2 or ≥3 doses of rotavirus vaccine, depending on the product used, by 8 months of age

e 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 the vaccine type, 3+Hep B, 1+varicella, and 4+PCV g Statistically significant difference from U.S estimate (p<0.05)

NIS-Child Immunization Coverage Estimates in the U.S., Texas and select local areas by 24 Monthsa of Age for Children born 2017-2018b

Vaccine

U.S.

Texas

Bexar
 County

City of
Houston

Dallas
County

El Paso
Countyg

4+DTaP

81.6%

77.4%

71.6%

77.6%

70.9%

-

3+Polio

92.7%

90.6%

89.9%

90.8%

90.3%

94.6%

1+MMR

91.6%

90.9%

92.1%

91.6%

89.1%

-

Hib-FSc

80.2%

76.0%

71.1%

78.7%

73.5%

-

Hep B Birth

78.4%

79.8%

76.3%

82.6%

77.9%

90.2%

3+HepB

91.9%

88.0%

89.5%

88.9%

87.9%

96.0%

1+VAR

90.9%

89.6%

90.1%

90.0%

88.5%

-

4+PCV

82.3%

79.9%

75.3%

79.1%

76.6%

-

1+HepA

87.0%

88.4%

85.7%

89.4%

86.1%

-

Rotad

75.6%

74.3%

72.0%

73.4%

70.5%

85.7%

2+Flue

60.6%

52.6%

55.2%

52.6%

40.4%

-

4:3:1:3 c:3:1:4f

70.5%

65.9%

61.6%

65.2%

62.4%

-

a Coverage estimates are at 24 months unless otherwise noted (i.e. rotavirus vaccine coverage assessed at 8 months)

b 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 from survey years 2018, 2019, and 2020; data for the 2018 birth year are considered preliminary and come from survey years 2019 and 2020 (data from the survey year 2021 are not yet available).

c Full series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on the vaccine type

d Either ≥2 or ≥3 doses of rotavirus vaccine, depending on the product used

e 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 the vaccine type, 3+Hep B, 1+varicella, and 4+PCV

g Vaccination coverage estimates for some vaccines were not included due to small sample sizes (-)

a Coverage estimates are at 24 months unless otherwise noted (i.e. rotavirus vaccine coverage assessed at 8 months)

b Data for the 2018 birth year are considered preliminary and come from survey years 2019 and 2020

c Full series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on the vaccine type

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 the vaccine type, 3+Hep B, 1+varicella, and 4+PCV

 

a Coverage estimates are at 24 months unless otherwise noted and for children born 2017-2018 (i.e. rotavirus vaccine coverage assessed at 8 months)

b Data for the 2018 birth year are considered preliminary and come from survey years 2019 and 2020

c Full series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on the vaccine type

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 the vaccine type, 3+Hep B, 1+varicella, and 4+PCV