BACKGROUND:
Beginning in 2002, the Advisory Committee on Immunization Practices (ACIP) encouraged, when feasible, that all children 6-23 months of age and the household contacts and out-of-home caregivers of children <2 years of age receive influenza vaccination each influenza season. National estimates of influenza vaccination coverage among these children, by demographic characteristics, have not been previously reported.

OBJECTIVE:
This study reports influenza vaccination coverage for the 2002-03 influenza season among children aged 6-23 months by demographic characteristics.

METHOD:
Data from the 2003 National Immunization Survey (NIS) were analyzed. The NIS is a national, random-digit-dial telephone survey that provides estimates of vaccination coverage among non-institutionalized children aged 19-35 months at the time of the household interview. Two measures of childhood influenza vaccination are reported: 1) receipt of one or more influenza vaccinations, and 2) fully vaccinated against influenza. Only children aged 6-23 months during September – December 2002 are included in the analyses. Chi-square tests were performed to test for associations between influenza vaccination status and demographic characteristics.

RESULT:
Overall, only 7.4% of children aged 6-23 months received one or more influenza vaccinations and only 4.4% were fully vaccinated. Influenza vaccination coverage was lower among: children living below the poverty level; non-Hispanic black children; children with less educated, unmarried, or young mothers; those with 4 or more children living in the household; children visiting only public clinics for vaccination; and children not up-to-date for other recommended vaccinations (all P<0.05).

CONCLUSION:
During the first year of the ACIP encouragement for children aged 6-23 months to receive influenza vaccination, coverage was very low with significant demographic differences in receipt of the vaccination. For the 2004-05 influenza season, an ACIP recommendation replaces the weaker encouragement previously in place. Substantial work remains to fully and equitably implement this new recommendation.

LEARNING OBJECTIVES:
To describe influenza vaccination coverage among children aged 6-23 months during the 2002-03 influenza season, the first year of the ACIP encouragement.