During the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) released the National Immunization Survey (NIS) and NIS-Teen data. Because of the stay-at-home orders earlier in 2020, most recently, we have all been hearing and thinking about how to recover immunization rates, which fell precipitously (See these MMWR publications from May 15, 2020 and May 22, 2020 for more information). As such, some people may have missed the NIS and NIS-Teen publications.

While recovering immunization rates is critical, we cannot forget what these important data show related to immunization rates prior to the pandemic. See how you do answering the following questions that highlight some of the findings.

Questions about NIS findings

1. Which vaccine had the lowest percent coverage rates?

  1. Hepatitis B
  2. Influenza
  3. MMR
  4. Varicella

Answer: B. While improvements since the last NIS were observed with two-dose coverage of influenza vaccine (from 53.8% to 58.1%), this vaccine still had the lowest coverage rates. Further, the authors pointed out that since the NIS measures immunization coverage through 24 months of age, many children would technically have been recommended to receive three doses (two doses separated by one month in the first year and one dose in the second year); therefore, coverage rates were likely lower than the estimates presented in the report.

2. Why were the authors so concerned about influenza vaccine coverage rates?

  1. Influenza is so contagious.
  2. Children are more likely to die from influenza.
  3. The SARS-CoV-2 pandemic will complicate the 2020-2021 influenza season.
  4. None of these.

Answer: C. Co-circulation of influenza and SARS-CoV-2 viruses, both of which can cause severe illness and death, may strain public health and medical systems throughout the U.S.

3. What percentage of children did not receive any vaccines by 24 months of age?

  1. 1 of 100
  2. 2 of 100
  3. 3 of 100
  4. 4 of 100

Answer: A. The average rate of unvaccinated children was 1.2%, which has ranged from 0.9% to 1.5% in NIS surveys of children born between 2011 and 2017.

4. Which group of children had the highest rate of non-vaccination?

  1. Children covered by private insurance
  2. Children covered by any type of Medicaid
  3. Children covered by other types of insurance
  4. Children without insurance coverage

Answer: D. About 4 of 100 children without insurance coverage had not received any vaccines, compared with 1 to 2 of 100 children with any type of insurance.

Check out the complete set of NIS findings.

Questions about NIS-Teen findings

1. Which adolescent vaccine had the lowest coverage rates?

  1. HPV
  2. Meningococcus ACWY
  3. Meningococcus B
  4. Tdap

Answer: C. While rates of meningococcal B vaccination improved from 17.2% to 21.8%, the reality is that only 2 of 10 adolescents are being actively protected against the potentially deadly disease caused by meningococcal type B.

2. While rates of vaccination are increasing among adolescents, 4 or 5 of every 10 adolescents are:

  1. Not considered up to date on HPV and meningococcal ACWY because they did not get all recommended doses
  2. Not getting Tdap vaccine
  3. Immune to varicella because of exposure to disease
  4. All of these

Answer: A. Only 53.7% of 17-year-old teens surveyed had received at least two doses of meningococcal ACWY, and only 54.2% of 13- to 17-year-olds surveyed were considered up to date on HPV vaccine.

3. According to the authors, improvements in on-time HPV vaccination (starting vaccination by age 13) were the result of which of the following?

  1. More parents deciding to protect their children against HPV-associated cancers
  2. Prioritization of HPV vaccination efforts among various stakeholders
  3. Reduction in number of doses recommended for those younger than 15 years of age
  4. All of these

Answer: D. All of the ideas listed were considered to be contributing factors to improving HPV vaccination by 13 years of age.

4. Providers were recommended to take which of the following steps to increase adolescent vaccination rates?

  1. Promote well visits
  2. Use reminder-recall systems
  3. Follow guidance related to COVID-19 safety procedures
  4. Ensure that families are aware of publicly funded vaccine programs, like VFC, if they might be eligible, particularly given that many people have recently lost private insurance coverage
  5. All of these

Answer: E. All of these recommendations were made for healthcare providers to ensure that adolescents are up to date on vaccinations.

Check out the complete set of NIS-Teen findings.

Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.