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North Carolina Immunization Branch


N.C. Immunization Rates

CDC’s National Immunization Survey - 19 - 35 months

The National Immunization Survey (NIS) external link is sponsored by the National Center for Immunizations and Respiratory Diseases (NCIRD) and conducted jointly by NCIRD and the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. The NIS is a list-assisted random-digit-dialing telephone survey followed by a mailed survey to children’s immunization providers that began data collection in April 1994 to monitor childhood immunization coverage.

The 2009 National Immunization Survey (NIS) results show North Carolina children are among the best-protected in the nation against vaccine-preventable diseases.  The survey shows 76.7 percent of children 19 to 35 months of age are up to date on all their routine childhood immunizations.  That’s better than the national average of 70.5 percent.  The rate gives North Carolina a fourth-place rank among states for 2009.

The table below shows the percentage of North Carolina children who are fully up to date on individual vaccines compared to children nationally:

  Estimated Vaccine Coverage Percentage
Vaccine North Carolina National Average
DTaP (4 doses) 85.9 83.9
Polio (3 doses) 92.9 92.8
MMR (1 dose) 92.9 90.0
Hib (3 dose - S)* 92.1 90.1
Hepatitis B (3 doses) 93.9 92.4
Varicella (1 dose) 91.9 89.6
Pneumococcal (4 doses)** 84.0 80.4
Hepatitis A** (2 doses) 47.5 46.6
Rotavirus** (1 dose) 41.1 43.9
Overall (4:3:1:0:3:1:4 series)*** 76.7 70.5

*Availability of Hib vaccine was affected by a nationwide shortage from 2007 to 2009. The shortage is now completely resolved.

**Pneumococcal, Hepatitis A and Rotavirus vaccines are not required in North Carolina.

***The overall series (4 DTaP: 3 Polio: 1 MMR: 0 Hib: 3 Hep B: 1 Varicella: 4 Pneumococcal) does not take Hib vaccination coverage into account because of the nationwide shortage.

CDC’s National Immunization Survey - Teen (13 - 17 year olds)

The 2009 Teen NIS measured immunization coverage among adolescents 13 to 17 years of age. It showed teen immunization coverage rates are improving in North Carolina. This survey assessed coverage rates for MMR, Hepatitis B, Varicella, Td or Tdap, Meningococcal and HPV vaccines.

  Estimated Vaccine Coverage Percentage
Vaccine North Carolina U.S.
  2008 2009 2009
MMR (2 doses) 82.2 84.1 89.1
Hepatitis B (3 doses) 81.4 86.9 89.9
Varicella (1 dose) 57.7 81.3 87.0
Varicella (2 doses) n/a 54.0 48.6
Td or Tdap (1 dose) 63.6 73.8 76.2
Tdap (1 dose) 28.0 54.7 55.6
Meningococcal (1 dose) 30.7 46.8 53.6
HPV (1 dose)* 34.4 50.3 44.3

*Human papillomavirus vaccine, either quadrivalent or bivalent. The percentage reported is among females only.

Although North Carolina was slightly below the national average for most of these vaccines in 2009, the data show our state is moving in the right direction. Our teen coverage rate for Tdap went from 28 percent in 2008 to 54.7 percent in 2009. This dramatic jump is likely due to the new state rule requiring a Tdap vaccine before entering the 6th grade. The 2009 Teen NIS assessed teens born from January 1990 to February 1996. Some of those included in the survey were too old to be affected by the new Tdap state rule.

The NIS serves as a valuable tool to measure North Carolina immunization rates and provides a reminder that vaccine-preventable diseases exist and can only be effectively controlled, and eventually eradicated, with high vaccine coverage levels.

Annual Local Health Department Assessment

Every year the Branch conducts immunization assessments to determine the percentage of children that are up to date on recommended vaccines by 2 years of age.  The assessment is completed through the NCIR and includes rates organized by local health department (LHD) and by county.  Local health departments rely on private providers to help ensure all children in their communities are appropriately vaccinated.

The data listed below show the average statewide rate broken down by LHD and by county.  County rates are determined by assessing all the children living in a particular county (whether the child is served by the LHD or not.)   The series measured is 4 DTaP, 3 Polio, 1 MMR, 3Hib, 3 Hep B, and 1 Varicella vaccination series.

  2010 2011
Average LHD Rate 86% 88%
Average County Rate 63% 65%

It’s important to understand that assessment rates are not immunization coverage rates. Refer to the Assessment Explanation of Immunization Compliance Rates for a more detailed explanation.

LHDs and private providers can run their own assessment reports any time they wish.  For instructions, review the Guidelines for Assessments and Reminder Recall(PDF, 33KB) on our website.  You can also schedule a visit with your Regional Immunization Consultant to conduct a thorough assessment through our AFIX program.  AFIX stands for Assessment of clinical vaccination coverage, Feedback of the information to the clinic, Incentives to clinics and promotion of eXchange of information among clinics.

Immunization assessments help providers quantify the immunization services they provide and capture information on patients who need additional immunizations.  It’s a useful tool that’s worth exploring.

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