Objective: To obtain estimates on (1) the percentage of children who were up-to-date on the recommended childhood vaccination series, (2) the percentage of children who were age-appropriately immunized, and (3) coverage levels by individual vaccines.
Design: Vaccination levels were estimated by conducting retrospective immunization coverage surveys of the school health records of children entering kindergarten or first grade in the 1990-1991 or 1991-1992 school year. A multistage cluster survey design was used.
Setting: Survey sites were selected from among the 60 largest urban areas in the United States. One small city and one rural area were selected for comparison.
Results: By their second birthday, 11% to 58% (median, 44%) of the children were fully vaccinated. Stricter measurement criteria lowered coverage levels further. Completed series levels at school entry were 71% to 96% (median, 87%).
Conclusions: Vaccination levels at the second birthday were far below the goal for the year 2000. All health providers need to administer vaccines according to the recommended schedule.