Background: Few interventions in medicine can compare with the efficacy, cost-effectiveness, and public health impact of routine immunizations in children. The 1993 Childhood Immunization Initiative (CII) established the goal of increasing coverage among 2 year-old U.S. children to ≥90% by 1996 for all doses of each routinely recommended vaccine, except hepatitis B vaccine (HBV, 70% for 1996 and 90% for 1998).

Objective: To determine progress in coverage among 19-35 month-old children since 1992.

Methods: 1992 National Health Interview Survey (area probability sampling with face-to-face interviewing) and 1994-96 National Immunization Survey(random-digit-dialing telephone survey with immunization provider record check component) data were studied.

Results: Compared with 1992, 1996 national coverage increased significantly for ≥3 doses of DTP (from 83% to 95%), ≥3 poliovirus vaccine (PVV, from 72% to 91%), ≥1 MMR (from 83% to 91%), ≥3 Hib (from 28% to 92%), and≥3 HBV (from 8% to 82%). The 4:3:1:3 (i.e., ≥4 DTP, ≥3 PVV, ≥1 MMR, and ≥3 Hib) series coverage was 72% in 1994 (when first measured) and 77% in 1996. This may reflect continuing low coverage with the fourth dose of DTP (77% in 1994 and 81% in 1996).

Conclusion: Although national vaccination coverage has improved substantially since 1992 and has met the 1996 CII individual vaccine goals, immunization providers need to intensity efforts, so that more children are fully protected with all doses of each recommended vaccine.