Childhood Immunization Status (CIS)

The percentage of children 2 years of age who had a four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); three haemophilus influenza type B (HiB); three hepatitis B (HepB), one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (HepA); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday.

The measure calculates a rate for each vaccine and nine separate combination rates.

Why It Matters?

Childhood vaccines protect children from a number of serious and potentially life-threatening diseases such as diphtheria, measles, meningitis, polio, tetanus and whooping cough, at a time in their lives when they are most vulnerable to disease.¹′² Approximately 300 children in the United States die each year from vaccine preventable diseases.³

Immunizations are essential for disease prevention and are a critical aspect of preventable care for children. Vaccination coverage must be maintained in order to prevent a resurgence of vaccine-preventable diseases.⁴

Results – National Averages

Influenza

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	66.1	63.4	41.2
2021	72.1	70.5	47.6
2020	71.8	69.6	50.7
2019	69.8	67.2	49.8
2018	67.3	65.4	46.9
2017	66.1	64.5	47.4
2016	64.5	62.3	45.3
2015	64.8	61.0	45.7
2014	66.6	63.5	51.1
2013	65.3	61.3	50.0
2012	63.3	59.8	49.5
2011	61.1	57.3	44.8
2010	57.1	51.1	43.6

Childhood Immunization Status Combination 10

(DTAP, IPV, MMR, HIB, Hepatitis B, VZV, PCV, Hep A, RV, and Influenza)
Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	57.3	50	31.9
2021	61.2	52.4	35.9
2020	58.0	51.4	38.9
2019	57.9	49.7	38.1

Childhood Immunization Status Combination 2

(DTAP, IPV, MMR, HIB, Hepatitis B and VZV)
Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2020	76.2	69.5	70.4
2019	79.7	71.4	73.4
2018	79.5	72.8	70.9
2017	78.6	71.2	72.9
2016	78.5	69.6	73.0
2015	78.4	66.8	72.5
2014	80.1	68.5	73.8
2013	78.8	67.5	74.0
2012	79.7	68.1	75.7
2011	78.0	64.8	74.5
2010	78.5	48.5	74.1
2009	77.7	43.1	74.3
2008	81.2	30.6	73.7
2007	80.8	30.1	72.1
2006	79.8	24.5	73.4
2005	77.7	54.8	70.5
2004	72.5	-	63.1
2003	69.8	-	58.4
2002	62.5	-	53.2
2001	57.6	-	52.5
2000	53.5	-	-
1999	47.5	-	-

* Childhood Immunization Status Combo 2 measure was retired in MY 2021.

Childhood Immunization Status Combination 3

(DTAP, IPV, MMR, HIB, Hepatitis B, VZV and PCV)
Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	79.3	70.1	63.2
2021	78.8	68.2	63
2020	74.8	67.7	67.6
2019	78.0	69.5	70.3
2018	77.7	71.3	68.1
2017	76.8	69.5	69.4
2016	76.5	68.9	69.7
2015	76.3	68.4	69.0
2014	78.0	69.0	70.4
2013	76.6	66.5	70.8
2012	76.8	65.8	72.1
2011	75.7	63.1	70.6
2010	75.1	46.1	69.9
2009	73.4	40.4	69.4
2008	76.6	28.5	67.6
2007	75.5	27.6	65.4
2006	65.7	22.4	60.9

Diptheria, Tetanus, Acellular Pertussis (DTAP/DT)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	85.4	80.9	69.7
2021	85.2	80.1	69.7
2020	83.4	79.2	73.9
2019	86.3	79.7	77.1
2018	85.8	80.9	75.0
2017	85.3	80.4	76.3
2016	85.3	79.6	76.8
2015	85.9	77.5	76.3
2014	87.3	80.2	78.0
2013	86.7	80.3	79.0
2012	87.2	80.0	80.9
2011	86.5	76.8	79.8
2010	86.3	64.7	80.2
2009	85.4	59.9	79.6
2008	87.2	47.7	78.6
2007	86.9	42.4	77.8
2006	87.2	39.2	79.3
2005	86.1	62.8	76.9
2004	85.9	-	75.6
2003	84.3	-	72.6
2002	80.1	-	69.4
2001	81.5	-	71.2
2000	80.4	-	-
1999	78.7	-	-

Hepatitis B (HEP B)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	88.5	78.8	84.5
2021	88	76.4	84.9
2020	83.7	75.3	87.3
2019	86.7	75.3	88.2
2018	87.3	79.1	87.1
2017	86.3	78.6	88.2
2016	85.4	77.1	88.0
2015	86.5	74.8	87.7
2014	88.9	77.9	89.3
2013	88.1	76.8	88.6
2012	89.2	77.3	89.5
2011	87.9	74.7	88.8
2010	90.2	58.7	90.1
2009	90.1	53.7	89.1
2008	91.8	38.7	88.3
2007	91.3	35.8	87.2
2006	91.0	31.1	88.4
2005	90.0	57.7	85.4
2004	87.2	-	81.9
2003	85.8	-	79.5
2002	81.9	-	76.2
2001	79.9	-	75.4
2000	77.9	-	-
1999	75.5	-	-

Haemophilis Influenza Type B (HIB B)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	91.6	87.3	82.3
2021	91.5	86.9	82.6
2020	89.7	85.8	85.9
2019	91.7	85.8	87.4
2018	91.4	87.1	86.3
2017	91.6	86.8	87.7
2016	91.3	86.0	88.1
2015	91.9	84.5	87.6
2014	93.7	87.5	89.3
2013	93.5	88.1	90.7
2012	94.3	88.3	92.0
2011	94.1	86.1	91.0
2010	94.3	75.5	90.3
2009	94.8	74.8	93.7
2008	94.8	66.3	93.4
2007	93.1	53.6	87.7
2006	93.4	49.2	89.1
2005	92.9	72.6	86.8
2004	87.7	-	79.1
2003	86.1	-	77.7
2002	83.2	-	73.8
2001	83.4	-	74.9
2000	82.7	-	-
1999	80.7	-	-

Inactivated Polio Virus (IPV)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	91.5	87	84.2
2021	91.5	86.4	84.7
2020	89.4	85.1	87.7
2019	91.3	85.1	88.7
2018	91.3	86.4	87.5
2017	90.6	85.5	88.2
2016	90.4	84.9	88.7
2015	90.7	82.5	87.7
2014	92.3	85.7	89.0
2013	92.2	86.2	90.0
2012	92.8	86.3	91.6
2011	92.4	83.4	90.5
2010	91.8	71.1	90.8
2009	91.1	65.3	89.0
2008	92.1	52.6	87.9
2007	91.5	47.5	87.3
2006	91.4	43.0	87.9
2005	90.3	66.7	84.7
2004	90.1	-	84.8
2003	88.7	-	83.1
2002	86.0	-	80.3
2001	85.4	-	79.1
2000	84.2	-	-
1999	82.6	-	-

Measles, Mumps, Rubella (MMR)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	92.1	90	83.5
2021	92	90.3	83.1
2020	92.4	90.5	87.6
2019	92.6	90.7	88.8
2018	92.3	90.3	87.5
2017	92.5	90.4	88.8
2016	92.8	90.5	89.5
2015	93.0	89.9	89.2
2014	92.1	89.1	90.0
2013	91.5	88.7	90.5
2012	91.8	88.3	91.6
2011	91.5	86.9	90.9
2010	90.8	82.7	90.6
2009	90.6	80.5	91.2
2008	93.5	76.4	90.9
2007	93.5	76.3	90.4
2006	93.6	75.0	91.1
2005	93.0	86.2	89.6
2004	92.3	-	88.1
2003	91.5	-	87.4
2002	90.1	-	84.4
2001	89.4	-	83.7
2000	88.4	-	-
1999	87.0	-	-

Pneumococcal Conjugate (PCV)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	86.5	81.9	70.8
2021	86	80.9	70.7
2020	84.2	80.1	75.6
2019	86.5	80.3	77.3
2018	86.1	81.5	75.7
2017	85.7	80.9	76.8
2016	85.4	79.9	77.2
2015	85.9	77.7	76.5
2014	87.5	80.4	78.3
2013	87.0	78.3	79.2
2012	86.7	78.9	80.1
2011	87.0	77.7	79.3
2010	85.6	65.6	79.4
2009	84.6	60.1	77.6
2008	84.8	47.8	75.6
2007	83.6	42.3	73.8
2006	72.8	37.1	68.3

Varicella (VZV)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	91.7	89.7	83.2
2021	91.7	89.8	82.9
2020	91.5	89.8	87.0
2019	92.0	89.9	88.4
2018	92.0	89.7	87.3
2017	92.0	90.0	88.6
2016	92.0	89.5	89.0
2015	91.9	88.6	88.8
2014	92.0	88.6	88.8
2013	91.5	88.3	90.2
2012	91.6	88.0	91.1
2011	91.3	86.9	90.5
2010	90.8	82.2	90.0
2009	90.6	79.7	90.6
2008	92.0	74.8	89.7
2007	91.9	74.4	88.7
2006	90.9	72.0	88.9
2005	89.9	82.0	86.6
2004	87.5	-	84.7
2003	85.7	-	81.8
2002	82.0	-	76.4
2001	75.3	-	73.6
2000	70.5	-	-
1999	63.8	-	-

Hepatitis A (Hep A)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	89.6	87.6	80.8
2021	89.5	87.9	79.9
2020	89.5	87.7	84.1
2019	89.1	87.2	85.3
2018	88.2	86.7	83.5
2017	87.8	85.8	84.3
2016	86.8	84.6	84.2
2015	85.5	83.1	83.7
2014	83.7	81.8	83.4
2013	82.5	79.3	81.9
2012	65.5	61.1	76.4
2011	39.0	32.2	39.2
2010	35.4	28.6	36.5

Rotavirus (RV)

Measure Year	Commercial HMO	Commercial PPO	Medicaid HMO
2022	84.8	80.1	68.2
2021	84.2	79	68.4
2020	82.2	77.7	71.2
2019	83.3	77.0	71.1
2018	82.9	77.8	69.6
2017	81.8	77.0	70.1
2016	80.5	75.5	69.0
2015	80.2	72.8	67.9
2014	80.8	74.6	68.1
2013	79.9	71.9	67.7
2012	76.7	69.8	66.0
2011	75.1	67.2	62.4
2010	63.5	51.9	57.6

This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.

Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via my.ncqa.org for analysis that accounts for trend breaks.

References

Mayo Clinic. 2014. “Infant and Toddler Health.Childhood Vaccines: Tough questions, straight answers. Do vaccines cause autism? Is it OK to skip certain vaccines? Get the facts on these and other common questions.” http://www.mayoclinic.com/health/vaccines/CC00014
Institute of Medicine. January 2013. “The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies.” Report Brief.
gov. 2013. “Immunizations and Infectious Diseases.” http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=23
Diekema, D.S. 2012. “Improving Childhood Vaccination Rates.” N Engl J Med 366:39;1-3 http://www.nejm.org/doi/full/10.1056/NEJMp1113008

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