Public Provider
Immunization Assessments in Indiana
2004 Assessment Results
Data in this report was collected from
93 local health department sites and
36 non-health department public providers
from throughout Indiana and compiled by the
Indiana State Department of Health’s
Immunization Program.
Indiana State Department of Health
Immunization Program
2 North Meridian
Indianapolis, IN 46204
Published: 03/2005
Mitchell E. Daniels, Jr.
Governor
Indiana State Department of Health
Judith A. Monroe, MD, State Health Commissioner
Sue Uhl, J.D., Deputy State Health Commissioner
Community and Family Health Services Commission
Vacant, Assistant Commissioner
Immunization Program
Michael Runau, M.S., Program Director
Charlene Graves, M.D., Medical Director
Primary Author
Megan Steiger, M.P.H., Epidemiologist
Preface
The 2004 “Assessment of Indiana’s Public Health Clinic
Immunization Coverage Levels” report provides the results of assessments
conducted in 93 local health departments and 36 non-health department
public providers. Non-health department public providers receive publicly
funded vaccine, but are not affiliated with a local health department.
The public provider immunization assessment of 2004
continued to focus on the immunization coverage levels of patients aged 24
through 35 months (i.e. two-year old children), a cohort of children born
in 2001, who were seen by public immunization providers. To be considered
completely immunized by age two, each child must receive 4 vaccinations
for diphtheria, tetanus, and acellular pertussis (DTaP), 3 vaccinations
for polio, the first measles, mumps, and rubella vaccine (MMR), at least 3
vaccinations for Haemophilus influenzae type b (Hib), and 3 vaccinations
for hepatitis B (HepB). The data contained in this report represents the
immunization coverage levels of children who were 24 to 35 months of age
at the time of the assessment.
Highlights
-
An estimated 14,390 children born in 2001 were active
patients of local health department immunization clinics by the time
they were 24 to 35 months of age. The immunization status of 99.7
percent of these children was assessed in 2004.
-
An estimated 5,986 children born in 2001 were active
patients of the 76 non-local health department public providers by the
time they were 24 to 35 months of age. The immunization status of 35.9
percent of these children was assessed in 2004.
-
Immunization coverage rates for individual antigens of
diphtheria, tetanus, and acellular pertussis (DTaP); polio; measles,
mumps and rubella (MMR); Haemophilus influenzae type b (Hib); and
hepatitis B are presented in Table 2 along with vaccination series
rates.
-
The standard immunization series used for the 2004
assessment year was the 4 DTaP, 3 Polio, 1 MMR, 3 Hib, and 3 Hep B in
which local health departments reached a coverage level of 84.0% and
non-local health department public providers achieved a 74.7% coverage
level.
-
For the complete 4 DTaP; 3 Polio: 1 MMR: 3 Hib: 3 Hep B
vaccination series, 41.9 percent of local health departments and 25.0
percent of non-health department public providers had greater than 90
percent complete coverage by 24 months of age for their 2 year old
patient population.
Table 1. Summary of two-year old population
(2001 birth cohort) of Indiana public immunization providers for
2004.
| |
Local Health Departmentsa |
Non-health department public providersb |
|
Estimated number of children from 2001 birth cohort seen by
Indiana’s public immunization providers. |
14390 |
5986 |
|
Total number of children from 2001 birth cohort
included in the 2003 immunization assessment |
14352 |
2150 |
|
% of 2 year old patient population sampled |
99.7% |
35.9% |
|
|
a Data for all 93 local
health departments.
b In order to maintain significant sample sizes, immunization
assessments of the non-health department public providers (n=76)
were restricted to those with at least 25 patients in the 24 to 35
month old age range, resulting in a decrease in the number of
assessments included in this report (n=36) |
Table 2. Summary of individual antigen and
vaccination series completion levels, by 24 months of age, Indiana
public immunization providers for 2004.
| |
% Complete
Statewide |
| Local
Health Departments |
Non HD
public providers |
|
INDIVIDUAL ANTIGENS |
| |
3 DTaP (Diphtheria,
Tetanus, Pertussis) |
96.7% |
95.0% |
| |
4 DTaP (Diphtheria,
Tetanus, Pertussis) |
85.9% |
78.8% |
| |
3 Polio (Oral and
Inactivated) |
94.3% |
91.5% |
| |
1 MMR (Measles, Mumps,
Rubella) |
94.8% |
90.2% |
| |
3 Hib (Haemophilus
influenzae type b) |
94.2% |
92.6% |
| |
3 HepB (Hepatitis B) |
94.5% |
91.4% |
|
VACCINATION SERIES |
| |
4 DTaP: 3 Polio: 1 MMR |
85.0% |
76.8% |
| |
4 DTaP: 3 Polio: 1 MMR:
3 Hib |
84.7% |
76.2% |
| |
4 DTaP: 3 Polio: 1 MMR:
3 Hib: 3 HepB |
84.0% |
74.7% |
|
|
a In order to maintain significant
sample sizes, immunization assessments of the non-health department
public providers (n=76) were restricted to those with at least 25
patients in the 24 to 35 month old age range, resulting in a
decrease in the number of assessments included in this report (n=36) |
Table 3: CASA assessment levels for all public VFC
provider sites* in Indiana combined for assessment years 2000 through
2004
|
Overall
Two-Year Old Sample Coverage Levels |
|
Series |
2000 |
2001 |
2002 |
2003 |
2004 |
|
4:3:1 |
80.6% |
83.0% |
79.5% |
79.3% |
83.7% |
|
4:3:1:3 |
80.1% |
82.0% |
79.0% |
78.9% |
83.2% |
|
4:3:1:3:3 |
78.7% |
81.0% |
77.2% |
77.7% |
82.5% |
|
|
*Immunization rates for all public
providers include all local health departments and non-local health
department providers who received a CASA/AFIX assessment. |
|
|
|
Figure 1: Overall coverage levels of 2-year olds
seen by all public providers; 2000 (n=135), and 2001 (n=162), 2002
(n=165), 2003 (n=167), and 2004 (n=169). |
|
|
|
Figure 2. 4 DTaP: 3 Polio: 1 MMR: 3 Hib
immunization series coverage levels at 24 months of age by provider
type, non-local health departments (n=76) and local health
departments (n=93), in Indiana for 2004. |
|
|
|
Figure 3. 4 DTaP: 3 Polio: 1 MMR: 3 Hib: 3 Hep B
immunization series coverage levels at 24 months of age by provider
type, non-local health departments (n=76) and local health
departments (n=93), in Indiana for 2004. |
|
|
|
Figure 4. 4 DTaP: 3 Polio: 1 MMR: 3 Hib: 3 Hep B
immunization series coverage comparison for assessments completed in
local health department sites in 2003 (n=93) and 2004 (n=93). |
|
|
| Figure 5. 4 DTaP: 3 Polio: 1 MMR: 3 Hib: 3 Hep B
immunization series coverage comparison for assessments completed in
non-local health department sites in 2004 (n=74) and 2004 (n=76). |
Recommendations and Conclusions
-
Local health departments and non-local health department
public providers should work to increase their immunization coverage
levels to the Healthy People 2010 goal of 90 percent coverage level.
-
Although overall immunization rates on the 4:3:1:3:3
series have increased in 2004, local health departments suffered a
decline in the number of sites with rates above 90 percent. Local health
departments need to work to regain these rates.
-
Non-local health departments experienced an increase in
the number of sites with immunization rates above 90 percent on the
4:3:1:3:3 series. These sites should continue to keep up the good work
and provide an example to other sites striving for those rates.
-
Providers need to remain up-to-date on ACIP
recommendations in regard to the childhood immunization schedule. VFC
providers are notified by the Immunization Program (i.e. through
informational updates) when updates have been made to the schedule. A
current copy of the Recommended Childhood Immunization Schedule is
available through the VFC program or can be accessed on the Immunization
Program website (http://in.gov/isdh/programs/immunization.htm).
|