Press Briefing Transcripts

CDC will announce 2006 national and state vaccination coverage rates among young children and adolescents.

Moderator: Curtis Allen, August 30, 2007, Thursday August 30, 2007 11:30 a.m. ET

• LISTEN-ONLY AUDIO

OPERATOR: Good morning, and thank you all for holding. At this time your lines have been placed on listen-only until we open up for questions and answers. I would now like to turn the call over to Mr. Curtis Allen. Please go ahead, sir.

CURTIS ALLEN, MEDIA RELATIONS DIVISION, CENTERS FOR DISEASE CONTROL AND PREVENTION: This is Curtis Allen in the Media Relations Division at CDC. Today we will be announcing the 2006 national and state immunization coverage rates for children, and for the first time adolescents. Dr. Melinda Wharton, that is M-E-L-I-N-D-A W-H-A-R-T-O-N, M-E-L-I-N-D-A W-H-A-R-T-O-N, Deputy Director for the National Center for Immunization and Respiratory Diseases at CDC will be talking with you.

There is individual state data in the MMWR, and you can find that information for local stories in the MMWR. Two weeks ago, we announced that 75 percent of states have reported 95 percent or higher coverage of the routine immunization schedule at school entry. That was locally reported data, not from NIS.

I will turn it over to Dr. Wharton. If you have questions following the press briefing, you can call the CDC press office at 404-639-3286 - Dr. Wharton.

MELINDA WHARTON, DEPUTY DIRECTOR, NATIONAL CENTER FOR IMMUNIZATION AND RESPIRATORY DISEASES: Thank you, Curtis. Good morning. We′re delighted to have coming out in the MMWR this week the 2006 National Immunization Survey data, not only for 19 to 35-month-old children for 2006, but also for the first time ever coverage rates for adolescents. And the - on the child side, we continue to have record levels of immunization coverage, and I will go over that part first.

We are reporting in this article a series complete coverage that includes six vaccines that prevent 10 disease, diphtheria, tetanus, pertussis, polio, measles, mumps and rubella, Haemophilus influenza Type B, Hepatitis B and Varicella.

In 2006, we are reporting 77 percent of children 19 to 35 months of age have received this complete immunization series by that age group, compared with 76.1 percent in 2005. So we continue to have a very high level of vaccination coverage in this age group.

Thanks to this high level of coverage, which is really due to the good work of immunization providers, and the commitment of parents to get their children vaccinated, the diseases that the vaccines prevent are now at very low levels in this country, and that′s great news for everybody in the United States.

In addition to the series complete coverage, we also report the coverage with the individual vaccines, and I wanted to mention a couple of them that are some of the newer vaccines to be added to the early childhood schedule. Pneumococcal conjugate vaccine has increased substantially in the 2006 data compared to 2005. In 2005, 82.8 percent of children in the National Immunization Survey had received three or more doses, and that increased in the 2006 data, which we′re now reporting to 87 percent. For four or more doses, it went from 53.7 percent to 68.4 percent, and these are significant increases.

Varicella coverage continues to be high, although not quite reaching the 90 percent goal we have for individual vaccines. In 2005, it was 87.9 percent, and it′s 89.3 percent in the 2006 data. We′ve not seen any significant decreases in individual vaccine coverage comparing 2005 with 2006.

As we′ve seen in previous years, there is substantial variation from state to state, and if we look at the complete series, coverage is highest in Massachusetts at 83.6 percent, and lowest in Nevada at 59.5 percent.

The survey also collects information on 30 local areas, which are reported in the article. And among the local areas, complete series coverage is highest in Boston, Massachusetts at 81.4 percent, and lowest in Detroit at 65.2 percent.

While we′re very pleased with how high the complete series coverage is, we know we still have a way to go to reach the 80 percent goal for 2010, and the 90 percent coverage for individual vaccines. And we continue to see a small racial ethnic difference among 19 to 35-month-olds in receiving the complete recommended series. Among white non-Hispanic children, 77.9 percent of them had received a complete series, compared with 73.9 percent of black non-Hispanic children, so a four percent difference.

In looking further at the data, this four percent difference is really accounted for by difference in the frequency of poverty in these two groups. Children whose families are living below the poverty level are less likely to be vaccinated than children whose families are at or above the poverty level, and poverty is more common among the African American children. So we think this difference is really due to socioeconomic status, and not due to race, but it′s still a real difference that we need to work and address.

Of course since 1994, we′ve had the vaccines for children program which helps assure that all the children in the United States have access to the recommended vaccines, and that program has done a lot over the long run to address the much more marked disparities that we used to see back in the 1980s. But we clearly need to continue to focus on this, and dealing with disparity issues does remain a major program focus at the state and local level, as well as for us at the national level.

Curtis mentioned in the introduction that two weeks ago we did release data on school entry coverage for the 2006-2007 school year that were published in MMWR, and that report showed that 75 percent of states were reporting that at least 95 percent of children in their state had received these vaccines that ACIP recommends for school entry. So this is another measure at another age group to indicate that in fact we′re doing a good job of getting children vaccinated by the time they start to school.

Now moving to the adolescents, this is very exciting for us, since 2005, there have been three vaccines that have been specifically recommended for children at 11 to 12 years of age, in the pre-teen years. Those three vaccines are the meningococcal conjugate vaccine, which prevents invasive meningococcal disease. A tetanus and diphtheria with acellular pertussis vaccine formulation specifically for adolescents, and one of the products is also licensed for adults. And, of course, there is also the Human Papilloma Virus vaccine, or HPV vaccine.

All three of these vaccines are now recommended for administration at age 11 to 12, and so it′s very important for us as we work to implement these new recommendations to be able to monitor vaccination coverage in adolescents. And this teen module in the 2006 National Immunization Survey is the first time we′ve had immunization coverage data collected from households with provider verification. So it′s a big step, and it′s looking at the age group of 13 to - 13 to 17-year-olds to give us this snapshot of where we are with vaccination coverage in that age group.

What the data for 2006 show is that more than 80 percent of these 13 to 17-year-olds had received three or more doses of Hepatitis B vaccine, and two or more doses of MMR, and that probably reflects the standing recommendations that have been in place for a long time. Over 60 percent of adolescents 13 to 17 years of age have received at least one dose of diphtheria toxoid containing vaccine, either Td, the older vaccine, or the newer vaccine that has the cellular pertussis vaccine in it.

Of those, 11 percent of adolescents, 13 to 17 percent had received the new DTaP vaccine, and 49 percent of adolescents had received the Td vaccine, the older vaccine. And we also report coverage of 12 percent for the meningococcal conjugate vaccine that was licensed a few years ago.

The new survey information is a great start to let us know where we are with the program, and a great tool that will help us follow program implementation as we work on getting these new vaccines out there. But clearly we need to do more to get information to parents and healthcare providers, and to make sure that everyone has a good understanding of the recommendations and the health benefits that the vaccines provide.

It is going to take a lot of work to get the levels of coverage in adolescents that we currently have in childhood, but we think it′s possible to do it, and there′ll be a big payoff in terms of - in terms of prevention if we′re able to achieve that.

So I hope that the release of this information will help prompt parents to think about the vaccination status of their own children, and particularly if they′ve got an 11 to 12-year-old child, think about scheduling that pre-teen visit, and if they′ve got an older child who may need vaccines, it′s a good time to check into that as well.

The many diseases that were once a common and frightening part of life for people - my parent′s generation - are now pretty much gone. And we all hope that our children never have to experience these diseases. We want to keep them in the textbooks, and not in our - in our households, in our families or in our hospitals. And it′s really vaccines that help us do that.

The National Immunization Survey is a great tool for us to let us see how we′re doing with the program, and what we still need to do. It indicates that we′re doing well in the childhood program, but we′ve still got a ways to go with adolescents. Thanks to the parents and the people who get children vaccinated, we think we can get there. But it′s clear that the job isn′t done. Thank you.

ALLEN: OK, Laura (ph), we′ll open it up for questions now.

OPERATOR: Thank you. At this time if you would like to ask a question, please press star followed by one on your touch-tone phone. To withdraw your request, you may press star two. Once again to ask a question, please press star one. One moment for the first question, please.

Thank you, our first question comes from John Donnelly with the "Boston Globe."

JOHN DONNELLY, "BOSTON GLOBE": Hi, thanks for having this call. I have two questions, one′s parochial. I wonder what you attribute to why Boston and Massachusetts have such high rates - the highest rates in the country for immunization coverage. And the second question, looking more nationally, what good examples do you see around the country in terms of getting vaccination rates higher among those who are below the poverty line?

WHARTON: Regarding your first question, you know, I don′t think I can really comment on individual states, there′s a lot of factors that contribute to the variability that we see among states, certainly some of it has to do with the demographics of the population, mobility, poverty levels and so forth. And also a lot of it has to do with vaccine infrastructure. I think this is one where the local folks in Boston and in the state of Massachusetts probably can highlight for you the things that they believe have contributed to this, but I′m not sure I would want to do so.

On the broader issue of addressing these disparity issues, there′s been a lot of experience in trying to address this over the last few years, and one of the things is clearly that providing immunization services in multiple settings has been important, we′ve worked for a number of years, for instance, to try to get children who are participating in Women, Infant and Children or WIC programs to have immunization status assessed, or even immunization services provided in those settings. And we also believe that immunization information systems that help track the immunization status of individual children can really be part of the solution, because many children may move from provider to provider or community to community, and perhaps they really have received the vaccines, but it′s not in the records. So those are some of the things that help, but it is still a challenge.

And of course there′s the Vaccines for Children program as well, which I mentioned in the introductory remarks. That′s a national program that provides vaccines to poor children throughout the United States, and we believe that is a major part of what has contributed to us being able to get all the children in the United States, including the poor children, vaccinated as well as they are.

ALLEN: Next question.

OPERATOR: Thank you. Again, as a reminder, to ask a question, please press star one. Our next question comes from William Dunham with Reuters.

WILL DUNHAM, REUTERS: Yes, hi, this is Will Dunham with Reuters in Washington. I′m interested in your thoughts - your level of satisfaction of the numbers you′re seeing in terms of the adolescent vaccinations. And what are the - what are the goals and - the numerical goal, and how did you do in terms of hitting that?

WHARTON: Well our numerical goals for individual vaccines is to achieve 90 percent coverage five years after the vaccine recommendation is in place. So we don′t expect to be able to get high vaccine coverage immediately, it does take a while to do it. We haven′t reached the numerical goals for any of the disease - any of the vaccines that we were assessing in this age group, but coverage is still pretty high with both the Hepatitis B and MMR series. Where we really have a long way to go is with the vaccines that are more recently recommended, and again we′re not anywhere near having that five-year implementation period yet. It does take a while, but we think with a focus on delivering these vaccines for pre-teens that we will see increases in coverage over the next few years.

ALLEN: Next question, please.

OPERATOR: We have no further questions at this time, sir.

ALLEN: OK.

WHARTON: Just to elaborate a little, since there′s not another question in the queue. There are a number of preventive health services that we know based on the science of prevention that would benefit adolescent health, and at the same time this is an age group that seeks medical care much less frequently, and parents seek it for younger children who go to the doctor a lot more often. And the - we are hopeful that these new vaccines that are now recommended for pre-teens at 11 to 12 years of age can really provide the basis for getting young people of this age into a physician′s office where they can receive not only the vaccines, but these other preventive services that may really result in some improvements in health of adolescents.

ALLEN: OK. Still no other questions?

OPERATOR: We actually have a few questions now.

ALLEN: OK.

OPERATOR: And our next question is from Kirk Fernandez (ph) with ABC News.

KIRK FERNANDEZ (ph), ABC NEWS: Hi, thanks for taking my call here. Quick question, I′m just wondering if there′s any data out there, and you′ve mentioned it briefly on the HPV vaccine, if there′s any data out there in terms of vaccination rates for adolescents, or that pre-teen group.

WHARTON: Well we′re not reporting data on HPV because at the time this information was collected - at the time this information began to be collected, we didn′t even have a federal contract in place for it yet. So it really was very, very early. The vaccine was licensed in June 2006, and although we′re not reporting coverage data, I can tell you that the Vaccine for Children program has been implemented in all 50 states with states purchasing vaccine through VFC for the VFC eligible children. And we also understand based on information from the vaccine manufacturer that as of the end of June, 7.5 million doses have been distributed in the United States, for a new vaccine, that′s quite a number of doses.

ALLEN: Next question, please.

OPERATOR: Thank you. We have a follow-up question from Will Dunham with Reuters.

DUNHAM: Hi, just wanted to follow up. What what are the reasons that you′re seeing in terms of why some people do not have their children immunized? Is it not - you know, not knowing the value of it, is it a - an affirmative decision by some parents simply not to do it? What are the explanations?

WHARTON: Thank you for asking, that′s a great question. Although our series complete coverage - although it′s high, it′s not quite as high as we would like, but it′s not that the children who haven′t received the complete series are unvaccinated completely, most of them are only missing a couple of vaccines. So with one or two visits, they could get caught up if the providers checked the records, and made sure that the vaccines that were recommended for that child in fact were provided.

The number of parents who make a decision to not vaccinate their child thankfully continues to be small in the United States, but we know that there are parents who have concerns, and it′s important that the people who are working with those parents to provide healthcare for their children try to address their questions, answer their questions, and then provide them the information they need to make a good choice for their child.

So a lot of the issue with the parents who are only missing a few shots, it′s not that they didn′t want to get their child vaccinated, probably a lot of them think their child is vaccinated, but there′s a lot of vaccines recommended, it′s a complicated schedule, and record keeping can be difficult. And so that′s one of the reasons that we believe that the immunization registries or immunization information systems can be very helpful to make sure that both parents and providers can really understand what vaccines the child needs, and get that child up to date so that they are protected as much as we can against these diseases.

ALLEN: Next question, please.

OPERATOR: Thank you. Our next question is from Jeff Evans with "The Pediatric News".

JEFF EVANS, "THE PEDIATRIC NEWS": Hi, I was wondering if you can recommend any strategies for pediatricians or any family medicine physicians who are seeing children or adolescents, and what they might do to build some sort of strategies that - so they can always be checking on that at visits when they see these - their patients.

WHARTON: Well I think the most important thing is to at every visit assess immunization coverage, and deliver the vaccines that are recommended. Again immunization registries, or electronic medical records at the office level, which many practices are now using, provide great reminder systems so that it′s pretty much automatic. We know that reminder systems both for parents to let them know that the vaccine is due to come back into the office, and in the office levels to let them know that vaccines are needed at that visit are really an important part of delivering immunizations on time.

ALLEN: Next question, please.

OPERATOR: And, sir, we have no further questions at this time.

ALLEN: OK. In that case, we′ll wrap it up. Thank you very much for joining us today. If you have follow-up questions, you can call the CDC Media Relations Office at 404-639-3286. And again thank you very much.

OPERATOR: Thank you. This does conclude today′s conference call, we thank you for your participation.

END

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES