2021 National Immunization Survey Results
National Immunization Survey-Child (NIS-Child) 2021, 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 Centers for Disease Control and Prevention (CDC) conducts the National Immunization Survey–Child (NIS-Child) annually. It assesses the percent of young children vaccinated.
The NIS is the only population-based survey to provide national estimates of vaccination coverage among children in the United States. It also gives state, local area, and territorial estimates. This study collects data by administering telephone surveys to randomly selected households. To ensure accurate vaccination coverage estimates, survey data for children include immunization data. The data are collected through a mail survey of their pediatricians, family physicians, and other health care providers. During the telephone interview, we ask the parents and guardians of eligible children for consent to contact the children’s vaccination providers. The data are weighted to be representative of the population of children 24 months of age. They 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 towards 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. These 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 and Bexar County.
Survey Sample
The 2021 NIS-Child data was collected from 2019 to 2021. The national sample size was 29,598 children born in 2018-2019, with adequate provider data. Data collected in 2021 had a low interview response rate (22.9%). Adequate provider data was available for only 51.5% of those with completed interviews.
Vaccines Included
The NIS assesses the percent of children that are up to date with routinely recommended vaccinations. They collect information on the following vaccine series:
- 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 Coverage Estimates
NIS-Child Immunization Coverage Estimates in Texas and U.S. by 24 Monthsa, 2017-2021
|
Vaccine |
U.S. Children born 2018-2019b |
Texas Children born 2016-2017 |
Texas Children born 2018-2019b |
Texas Percentage point difference |
|---|---|---|---|---|
|
≥4 doses diphtheria, tetanus, acellular pertussis (4+DTaP) |
81.9% |
78.7% |
80.4% |
1.7% |
|
≥3 doses inactivated poliovirus (3+Polio) |
93.4% |
89.2% |
93.0% |
3.9%h |
|
≥1 dose measles, mumps, rubella (1+MMR) |
91.6% |
89.2% |
89.7% |
0.5% |
|
Haemophilus influenzae full series (Hib-FS)c |
80.0% |
76.7% |
78.7% |
2.0% |
|
1 dose Hepatitis B in first 3 days of life (Hep B Birth) |
79.8% |
77.8% |
83.5% |
5.7%h |
|
≥3 doses Hepatitis B (3+HepB) |
92.7% |
87.3% |
90.0% |
2.7% |
|
≥1 dose varicella (1+VAR) |
91.1% |
88.3% |
90.1% |
1.8% |
|
≥4 doses pneumococcal conjugate (4+PCV) |
83.5% |
79.3% |
83.9% |
4.7%h |
|
≥ 1 dose Hepatitis A (1+HepA) |
88.3% |
87.4% |
90.1% |
2.8% |
|
Rotavirus series (Rota)d |
77.1% |
71.4% |
79.9% |
8.5%h |
|
≥2 doses influenza (2+Flu)e |
63.9% |
51.3% |
55.3%g |
4.0% |
|
7-vaccine series (4:3:1:3c:3:1:4)f |
70.1% |
67.4% |
69.3% |
1.9% |
- a.) Coverage estimates are at 24 months unless otherwise noted (i.e. rotavirus vaccine coverage assessed at 8 months)
- b.) 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 2019 birth year are considered preliminary and come from survey years 2020 and 2021 (data from survey year 2022 are not yet available).
- c .) Full series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on vaccine type
- d.) Either ≥2 or ≥3 doses of rotavirus vaccine, depending on 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 vaccine type, 3+Hep B, 1+varicella, and 4+PCV
- g.) Statistically significant difference from U.S estimate (p<0.05)
- h.) Statistically significant difference from zero (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 2018-2019b, NIS-Child 2021
|
Vaccine |
U.S. |
Texas |
Bexar |
City of |
|---|---|---|---|---|
|
≥4 doses diphtheria, tetanus, acellular pertussis (4+DTaP) |
81.9% |
80.4% |
75.7% |
80.9% |
|
≥3 doses inactivated poliovirus (3+Polio) |
93.4% |
93.0% |
91.2% |
92.1% |
|
≥1 dose measles, mumps, rubella (1+MMR) |
91.6% |
89.7% |
89.1% |
91.2% |
|
Haemophilus influenzae full series (Hib-FS)c |
80.0% |
78.7% |
78.0% |
83.4% |
|
1 dose Hepatitis B in first 3 days of life (Hep B Birth) |
79.8% |
83.5% |
81.8% |
79.2% |
|
≥3 doses Hepatitis B (3+HepB) |
92.7% |
90.0% |
91.6% |
90.1% |
|
≥1 dose varicella (1+VAR) |
91.1% |
90.1% |
88.4% |
91.3% |
|
≥4 doses pneumococcal conjugate (4+PCV) |
83.5% |
83.9% |
81.4% |
86.0% |
|
≥ 1 dose Hepatitis A (1+HepA) |
88.3% |
90.1% |
87.5% |
92.0% |
|
Rotavirus series (Rota)d |
77.1% |
79.9% |
76.1% |
82.2% |
|
≥2 doses influenza (2+Flu)e |
63.9% |
55.3% |
63.7% |
61.7% |
|
7-vaccine series (4:3:1:3c:3:1:4)f |
70.1% |
69.3% |
67.4% |
72.3% |
- a.) Coverage estimates are at 24 months unless otherwise noted (i.e. rotavirus vaccine coverage assessed at 8 months)
- b.) 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 2019 birth year are considered preliminary and come from survey years 2020 and 2021 (data from survey year 2022 are not yet available).
- c.) Full series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on vaccine type
- d.) Either ≥2 or ≥3 doses of rotavirus vaccine, depending on 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 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 2019 birth year are considered preliminary and come from survey years 2020 and 2021
- c.) Full series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on vaccine type
- d.) 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 vaccine type, 3+Hep B, 1+varicella, and 4+PCV
- a.) Coverage estimates are at 24 months unless otherwise noted (i.e. rotavirus vaccine coverage assessed at 8 months)
- b.) Data for the 2019 birth year are considered preliminary and come from survey years 2020 and 2021
- c.) Full series (FS) of either 3 or 4 doses of Hib conjugate vaccine, depending on 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 vaccine type, 3+Hep B, 1+varicella, and 4+PCV
For access to the full dataset, go to the CDC Data and Documentation for NIS Surveys page.