Public Health Resources


Date of this Version



PEDIATRICS Volume 118, Number 3, September 2006


U.S. Government Work


BACKGROUND. Beginning in 2002 the Advisory Committee on Immunization Practices

encouraged, when feasible, annual influenza vaccination of all children aged 6 to

23 months and household contacts and out-of-home caregivers of children <2

years of age.

OBJECTIVE.We sought to report influenza vaccination coverage for the 2002–2003

and 2003–2004 influenza seasons among children aged 6 to 23 months according

to demographic and immunization-provider characteristics.

METHODS. Data from the 2003 and 2004 National Immunization Survey were analyzed.

Two measures of childhood influenza vaccination are reported: receipt of

>1 influenza vaccination and full vaccination (ie, receipt of the appropriate

number of doses on the basis of previous vaccination history). x2 tests and

logistic-regression analyses to test for associations between influenza vaccination

status and demographic characteristics were performed.

RESULTS. In the 2002–2003 and 2003–2004 influenza seasons only 7.4% and 17.5%,

respectively, of children aged 6 to 23 months received >1 influenza vaccination,

whereas only 4.4% and 8.4%, respectively, were fully vaccinated. In both seasons,

adjusted influenza vaccination coverage was significantly lower among children

living below the poverty level; non-Hispanic black children; older children; children

with less-educated mothers; children vaccinated only at public clinics; and

children not residing in a metropolitan statistical area.

CONCLUSIONS. During the first 2 years of the Advisory Committee on Immunization

Practices’ encouragement for children aged 6 to 23 months to receive influenza

vaccination, coverage was low, with significant demographic differences in receipt

of vaccination. Beginning with the 2004–2005 influenza season, they replaced the

encouragement with a recommendation that children aged 6 to 23 months receive

annual influenza vaccination. Substantial work remains to fully and equitably

implement this new recommendation and ensure vaccination with 2 doses for

previously unvaccinated children.