Summary


Introduction

Immunization remains a safe and effective method of preventing illness in children and stopping disease transmission in the community. The Advisory Committee on Immunization Practices (ACIP) provides a vaccine schedule to achieve protection against 14 diseases by 24 months of age. These include: diphtheria, tetanus, acellular pertussis, polio, measles, mumps, rubella, Haemophilus influenzae type b, hepatitis B, varicella, pneumococcal disease, hepatitis A, and influenza1. This report summarizes immunization coverage for children who were aged 19 through 35 months in the first quarter of 2023.

Methods

All immunization records and demographic data for children born between February 01, 2020 and August 31, 2021 were obtained from the Georgia Registry of Immunization Transactions and Services (GRITS). Records from out-of-state residents and placeholder records (those created for unnamed children at birth) were removed, resulting in 207,004 records. Each immunization record was evaluated using the ACIP 4:3:1:3:3:1:42 catch-up schedule. The catch-up schedule provides the minimum age and the shortest acceptable interval between immunizations. This allows us to identify children who were vaccinated appropriately but outside the recommended schedule due to missed vaccines, travel, contraindications, or other unknown reasons. If all doses of a vaccine (e.g., all 4 of the DTaP doses) were correctly administered by 35 months, the child was considered up-to-date on that vaccine.

Coverage was further examined by race, ethnicity, insurance status, district, and county.

Differences from Past Studies

Previous child immunization studies used a retrospective cohort research design where children who turned two in January were sampled from each district. Identifying information was collected from electronic birth records and vaccination history was collected primarily from GRITS. If the child’s record was not up-to-date, local public health staff contacted parents, guardians, and providers to obtain any missing immunization history data.

Limitations

Some immunization records have multiple addresses associated with them, either because of multiple parents/guardians listed or because old and new addresses are contained in the record. In these cases, the first complete Georgia address was used to assign county of residence. Children may not have received all vaccines while living at one address or at the assigned address. In cases where there was no address, the child was assumed to be a Georgia resident and county was left as “unknown.” Due to the volume of records, it is not feasible to individually determine correct addresses, and therefore county- and district-level coverage are estimates.

Key Findings

Overall, Georgia’s immunization coverage for the complete 4:3:1:3:3:1:4 series was 73.9%. By individual vaccines, coverage was highest for Pneumococcal conjugate vaccine (PCV) at 90.9% and lowest for Hepatitis A (HepA) at 64.1%. By race, coverage for the complete 4:3:1:3:3:1:4 series was highest among Asian at 79.7% and lowest among Unknown at 65.3%. By ethnicity, coverage for the complete 4:3:1:3:3:1:4 series was highest among Hispanic or Latino at 77.2% and lowest among Unknown at 66.7%. By district, coverage for the complete 4:3:1:3:3:1:4 series was highest in District 10 Athens at 80.3% and lowest in Unknown at 59.7%.

Footnotes

1 https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html

2 4 diphtheria, tetanus, acellular pertussis (DTaP) doses, 3 inactivated polio virus (IPV) doses, 1 measles, mumps, rubella (MMR) dose, 3 Haemophilus influenzae type b (Hib) doses, 3 hepatitis B (HepB) doses, 1 varicella dose, and 4 pneumococcal conjugate vaccine (PCV) doses

Using Buttons in this Report:

Click the “Report Sections Drop-Down” button to view and navigate to the different sections of the report. In the “Georgia Totals” and “Georgia Totals Overtime” sections, you can interact with the graphs. Click and drag to zoom in and double click to return to the default view. In the “Georgia Totals Overtime” section, you can also click the name of the vaccine in the legend to remove it from the graph, which can be helpful when lines overlap. In all the other report sections, there are buttons at the top to download the data into various formats. Copy will copy the chart onto your clipboard so you can paste it into other documents. You can download the data from the report section as CSV, Excel, or PDF with their respective buttons. Print will open the print menu so you can print a physical copy. In the “Data by District” and “Data by County” sections, you can use the search bar to limit the table to a particular district or county.

Georgia Totals

Georgia Totals Overtime

Data by Race

Data by Ethnicity

Data by Insurance Coverage

Data by District

Data by County