Trends in childhood influenza vaccination coverage--U.S., 2004-2012

Public Health Rep. Sep-Oct 2014;129(5):417-27. doi: 10.1177/003335491412900505.


Objective: We compared estimates of childhood influenza vaccination coverage by health status, age, and racial/ethnic group across eight consecutive influenza seasons (2004 through 2012) based on two survey systems to assess trends in childhood influenza vaccination coverage in the U.S.

Methods: We used National Health Interview Survey (NHIS) and National Immunization Survey-Flu (NIS-Flu) data to estimate receipt of at least one dose of influenza vaccination among children aged 6 months to 17 years based on parental report. We computed estimates using Kaplan-Meier survival analysis methods.

Results: Based on the NHIS, overall influenza vaccination coverage with at least one dose of influenza vaccine among children increased from 16.2% during the 2004-2005 influenza season to 47.1% during the 2011-2012 influenza season. Children with health conditions that put them at high risk for complications from influenza had higher influenza vaccination coverage than children without these health conditions for all the seasons studied. In seven of the eight seasons studied, there were no significant differences in influenza vaccination coverage between non-Hispanic black and non-Hispanic white children. Influenza vaccination coverage estimates for children were slightly higher based on NIS-Flu data compared with NHIS data for the 2010-2011 and 2011-2012 influenza seasons (4.1 and 4.4 percentage points higher, respectively); both NIS-Flu and NHIS estimates had similar patterns of decreasing vaccination coverage with increasing age.

Conclusions: Although influenza vaccination coverage among children continued to increase, by the 2011-2012 influenza season, only slightly less than half of U.S. children were vaccinated against influenza. Much improvement is needed to ensure all children aged ≥ 6 months are vaccinated annually against influenza.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Guideline Adherence / statistics & numerical data
  • Health Care Surveys
  • Humans
  • Infant
  • Influenza Vaccines / administration & dosage*
  • Influenza Vaccines / standards
  • Influenza, Human / complications
  • Influenza, Human / immunology
  • Influenza, Human / prevention & control*
  • Kaplan-Meier Estimate
  • Practice Guidelines as Topic
  • Risk Factors
  • United States


  • Influenza Vaccines