1. Healthy People 2010 Focus Area 14
Presented by:
Abigail Shefer, MD, FACP
CAPT, USPHS
Associate Director for Science
Immunization Services Division
National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention

2. Healthy People 2010 Focus Areas
Top 5 Focus Areas by # of Objectives*
Injury/Violence Prevention, 39 objectives
16 sub-objectives
Immunization/Infectious Disease, 31 objectives
18 Immunization objectives
55 sub-objectives
13 Infectious Disease objectives
5 sub-objectives
Environmental Health, 30 objectives
66 sub-objectives
Substance Abuse, 25 objectives
32 sub-objectives
Tobacco Use, 21 objectives
38 sub-objectives
*Numbers do not take into account mid-course deletions
**Half of Focus Areas range from objectives.
Immunization and Infectious Disease together have the 2nd highest number of objectives. Separated, Immunization has 18 objectives, but a large number of sub-objectives.

3. Immunization Target Overview
Reduction in # of cases Target
Individual vaccine-preventable diseases
95% Target
Maintain vaccination coverage levels for children in licensed day care facilities and children in kindergarten through first grade.
93% Target
Vaccination coverage of occupationally exposed workers with HepB
# of cases: drops in total number of cases or cases per 100,000
% Target refer to percentage of total population

4. Immunization Target Overview
Achieve/maintain coverage of universally recommended vaccines for month olds
Routine vaccination coverage levels for adolescents
HepB vaccination coverage in long term hemodialysis patients
Pneumococcal and seasonal flu vaccination coverage in both non-institutionalized adults 65+ and institutionalized adults
80% Target
19-35 months and yrs who receive all recommended vaccines

5. Immunization Target Overview
Proportion of children who participate in fully operational population-based immunization registries
60% Target
HepB vaccination coverage for MSM
Pneumococcal and seasonal flu vaccination coverage in non-institutionalized high-risk adults yrs
Seasonal Flu vaccine coverage for healthcare workers yrs
55% Target
providers assessment of vaccination coverage in their practice within last 2 years

6. Healthy People 2010 Immunization Sub-objectives by Year Target Met 1-b
Baseline
1999
2000
2001
2002
2003
2004
2005
2006
1-h***
22-b***
22-d***
22-e***
23-a***
23-b***
23-c***
27-b***
27-c***
30-a***
30-b***
1-b
30-a 7
23-a
30-b
5-a*
6**
22-c
23-f***
23-g***
23-h***
23-i***
23-l***
1-a
5-b*
23-j
24-a
3-d
23-l
Objectives were set to be consistent with HP2000 targets.
At data baseline year, the following goals were met:
1998:
Polio cases
Achieve/maintain universally recommended vaccines mo: Hib, MMR, polio,
Maintain vaccination coverage levels for children in licensed day care facilities:
Day care: DTaP, MMR, polio
Routine vaccination coverage among adolescents: MMR, Td (based on NCHS data, not NIS)
Adverse events from vaccination: associated paralytic polio, febrile seizures
2002/2003:
Maintain vaccination coverage levels for children in kindergarten:
Kindergarten: DTap, MMR, polio, HepB, Hib,
Pneumococcal conjugate vaccine (5a in 2001 and 5b in 2004) and targeted Hepatitis A (6) goals were met within 1-2 years of ACIP recommendation of the vaccine.
*Reduce invasive pneumococcal infections; pneumococcal conjugate vaccine recommended by ACIP in 2000.
**Reduce Hepatitis A; ACIP recommendation made in 1999
***Baseline year

7. Healthy People 2010 Immunization Objectives Met
1: Reduce or eliminate indigenous cases of vaccine preventable diseases
Met: Congenital Rubella Syndrome, Diphtheria, Polio,
Unmet: Hib, Hepatitis B, Measles, Mumps, Pertussis, Rubella, Tetanus, Varicella
3: Reduce Hepatitis B
Met: Adults, High-risk group injection drug users
Unmet: yrs, yrs, 40 yrs+, High risk groups Heterosexually active, MSM, occupationally exposed workers
14-1, 14-3, 14-5, 14-6 and 14-7 are all met through reduction in total number of cases.
1-Polio met at baseline/1998, Congenital rubella syndrome met 2004, Diphtheria met in 1999.
3-Hepatitis B among high risk group injection drug users met in 2005.

8. Healthy People 2010 Immunization Objectives Met
5: Reduce invasive pneumococcal infections
Met: New invasive infection in children, adults 65+
Unmet: Penicillin-resistant infection in children, adults 65+
6: Reduce Hepatitis A
7: Reduce meningococcal disease.
14-1, 14-3, 14-5, 14-6 and 14-7 are all met through reduction in total number of cases
5-for Pneumococcal infections, invasive infection in children met in 2001, invasive infection in adults 65+ met in 2004 (PCV4 recommended by ACIP in 2000)
6-hepatitis A met in 2001 (targeted hep A immunization recommended by ACIP in 1999.)
7-Meningococcal disease, met in 2000.

9. Healthy People 2010 Immunization Objectives Met
22: Achieve and maintain effective vaccination coverage levels for universally recommended vaccines among young children aged months
Met/Maintained: Hib, Hep B, MMR, Polio
Unmet: DTaP, Varicella, pneumococcal conjugate, influenza
23: Maintain vaccination coverage levels for children in licensed day care facilities and children in kindergarten
Met: Day care for DTaP, MMR, Polio: Kindergarten for DTap, MMR, Polio, Hep B
Unmet: Day care for Hep B, Varicella, pneumococcal conjugate, Hib
14-22 met at 90% coverage level
14-23 met at 95% coverage level
22-hib met at baseline/1998, HepB met in 2002, MMR met at baseline/1998, polio met at baseline/1998.
23-day care: DTaP met at baseline/1998, MMR met at baseline/1998, polio met at baseline/1998.
kindergarten: DTaP met at at baseline/2002, MMR met at baseline/2002, poplio met at baseline/2002,, HepB met at baseline/2002

10. Healthy People 2010 Immunization Objectives Met
24: Increase the proportion of young children who receive all vaccines that have been recommended for universal administration for at least 5 years
Met: mo with all vaccines
Unmet: yr with all vaccines
27: Increase routine vaccination coverage levels of adolescents
Met: MMR, Td
Unmet: Hep B, Varicella
30: Reduce vaccine-associated adverse events.
14-24 met at 80% coverage level
14-27 met at 90% coverage level
months met in 2004.
27--was based on flawed NCHS data, showing it was met in baseline/ NIS 2006 data shows that Td and MMR are below target

11. Number of Vaccines in the ACIP Routine Childhood and Adolescent Immunization Schedule
HP2010 Launch
ACIP 2008
Measles
Rubella
Mumps
Diphtheria
Tetanus
Pertussis
Polio
Hib (infant)
HepB
Varicella
Pneumococcal
Influenza (6 mo-18 yrs)
Meningococcal
HepA
Rotavirus
HPV
Measles
Rubella
Mumps
Diphtheria
Tetanus
Pertussis
Polio
Hib (infant)
HepB
Varicella
This slide demonstrates that since HP 2010 was originally released, there has been an increase in the number of routine recommended vaccines for the child and adolescent immunization schedule by ACIP. 10 16

12. Number of Vaccines in the ACIP Routine Adult Immunization Schedule
HP2010 Launch
ACIP 2008
Measles
Rubella
Mumps
Diphtheria
Tetanus
Pertussis
Varicella
Pneumococcal
Influenza
HPV
Zoster
Measles
Rubella
Mumps
Diphtheria
Tetanus
Varicella
Pneumococcal
Influenza
This slide demonstrates that since HP 2010 was originally released, there has been an increase in the number of routine recommended vaccines for the adult immunizations schedule by ACIP. 8 11

13. Discussion