BACKGROUND:
Timely vaccinations in early childhood are important for optimal protection against vaccine preventable diseases.

OBJECTIVE:
To examine the timeliness of vaccine administration among infants and young children for each state and selected urban area in the United States.

METHOD:
We analyzed age at receipt of vaccinations among children aged 24 to 35 months in the 2001 National Immunization Survey in each state and 27 selected urban areas. We present the percent of children to receive all vaccinations as recommended, as well as those who received all vaccinations acceptably early or as recommended, percent who received at least one dose late or invalidly early, and the percent who were missing one or more doses by age 24 months. To facilitate interpretation, we present results via maps and individualized graphs that allow appropriate comparison of each state to all others.

RESULT:
Receipt of all vaccinations as recommended varied widely by state, from 2-3% in Mississippi and Alaska to 19-21% in Massachusetts and Rhode Island. Regional differences in timely vaccinations are shown by maps. Graphs comparing results in each individual state to other states show considerable overlap between states.

CONCLUSION:
While traditional coverage measures focus on the number of vaccinations accumulated by specified ages, the results presented here focus on the timeliness of administration. State health departments can use information on the timeliness of vaccinations as a measure of their children’s level of susceptibility to vaccine preventable diseases, and to evaluate the quality of vaccination programs.

LEARNING OBJECTIVES:
Participants will be able summarize the importance of timeliness of childhood immunization, gain an awareness of an appropriate method for comparing immunization coverage data among states, and take away a graph depicting the timeliness of childhood vaccination in their state compared to all other states.