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Epidemiologic Reviews Advance Access published online on June 1, 2006
Epidemiologic Reviews, doi:10.1093/epirev/mxj001
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Epidemiologic Reviews Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Accepted March 20, 2006

Article

Measuring Immunization Coverage among Preschool Children: Past, Present, and Future Opportunities

Daniel A. Salmon 1 *, Philip J. Smith 2, Ann Marie Navar 3, William K. Y. Pan 4, Saad B. Omer 3, James A. Singleton 2, and Neal A. Halsey 3

1 Department of Epidemiology and Health Policy Research, College of Medicine, University of Florida, Gainesville, FL; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
2 Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA
3 Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
4 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

* To whom correspondence should be addressed.
Daniel A. Salmon, E-mail: das{at}ehpr.ufl.edu


  Abstract

Control of vaccine-preventable diseases depends on maintaining high levels of immunization coverage. Immunization coverage among preschool children remains suboptimal in some areas and sociodemographic subgroups, as well as for more recently introduced vaccines, leaving susceptible young children vulnerable to complications from vaccine-preventable diseases. This paper reviews approaches historically used to measure immunization coverage among preschool children in the United States. The strengths and weaknesses of various approaches to measuring immunization coverage among preschool children are explored, with emphasis on the current means to measure national immunization coverage--the National Immunization Survey. Methods for measuring immunization coverage among preschool children at local and state levels are also evaluated. Future opportunities and challenges for measuring immunization coverage at the local, state, and national levels are explored.

Keywords: child health services; child, preschool; communicable disease control; comparative study; immunization programs; immunization schedule; vaccination.
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