Environmental Public Health Tracking: Immunization Data

Immunizations, or vaccinations, improve our bodies' ability to fight off disease. The CDC (Centers for Disease Control and Prevention) explains how vaccines prevent diseases on their website.

One aim of the National Environmental Public Health Tracking Network is to host data that researchers can use to better understand potential links between the environment and disease. Some diseases that are preventable by vaccines have clear links to the environment and to environmental health. For example, tetanus (lockjaw) is caused by bacteria found in soil and dust. Additionally, people living with asthma are at higher risk for severe disease and complications from influenza (flu), therefore, vaccination with the flu vaccine is especially important for this population.

Offering easy access to immunization data will allow researchers to identify and better understand the relationship between the environment and vaccine-preventable diseases and how immunization impacts these relationships.

Tracking immunization rates gives public health professionals a better understanding of how many people in a county have had their recommended vaccines. With Environmental Public Health Tracking, we can monitor what percentage of people have their recommended vaccines and can use that information to educate our communities and plan prevention efforts.

The source of the data is the Wisconsin Immunization Registry. The Wisconsin Immunization Program uses data from the Wisconsin Immunization Registry to tabulate rates by each type of immunization and sends this information to the Wisconsin Environmental Public Health Tracking Program.

The portal includes data on the following vaccines:

• Diphtheria, tetanus, and pertussis (DTaP) vaccine. Protects against diphtheria, tetanus (lockjaw), and pertussis (whooping cough) and is for children under seven.
• Haemophilus influenzae type B (Hib) vaccine
• Hepatitis B (Hep B) vaccine
• Human papillomavirus (HPV) vaccine
• Influenza (flu) vaccine
• Measles, mumps, and rubella (MMR) vaccine
• Meningococcal (MenACWY) vaccine. Protects against meningococcal disease (a cause of meningitis and bacteremia) caused by serogroups A, C, W, and Y.
• Pneumococcal (PCV13 and PPSV23) vaccine. Protects against pneumococcal disease (a cause of pneumonia, otitis media, and other diseases) in children (PCV13) and adults (PCV13 and PPSV23).
• Polio vaccine
• Tetanus, diphtheria, and pertussis (Tdap) vaccine. Protects against diphtheria, tetanus (lockjaw), and pertussis (whooping cough) and is routinely recommended for those age 11 years and older.
• Varicella vaccine. Protects against chickenpox.
• Zoster vaccine. Protects against shingles.
• 4:3:1:3:3:1:4 Childhood Vaccination Series. This vaccine series includes the vaccines that a child needs by the time they are two years of age. For a two year old to be up-to-date with their vaccines, they should have—at a minimum—the following vaccines: four doses of DTaP, three doses of polio, one dose of MMR, three doses of Hib, three doses of Hepatitis B, one dose of varicella, and four doses of PCV.

The data source is the Wisconsin Immunization Registry (WIR). Border counties with residents who receive immunizations in states that do not share data to the WIR might have higher immunization rates than reflected.

• Wisconsin Department of Health Services - Immunizations
• Centers for Disease Control and Prevention - Immunizations

• Wisconsin Department of Health Services - Vaccine Preventable Diseases
• Centers for Disease Control and Prevention - 14 Diseases You Almost Forgot About (Thanks to Vaccines)
• Centers for Disease Control and Prevention - Vaccines by Disease
• The Gates Foundation - How Can Data Help Fight Disease? (YouTube video)

Percent immunized by vaccine

The data source is the Wisconsin Immunization Registry (WIR). The WIR is a confidential database that collects immunization histories for Wisconsin residents. WIR collects the date and type of each vaccine a person receives. WIR receives data from local health departments, public and private health care providers, health maintenance organizations, pharmacies, tribal health centers/clinics, and schools. Reporting to WIR is voluntary except for pharmacists and pharmacies who vaccinate children and for Vaccines for Children (VFC) providers. Percent immunized is calculated by dividing the number of immunized individuals (numerator) by the population in the selected age group and geographic area (denominator). For the non-influenza vaccines, the population (i.e., denominator) is obtained from the WIR and is equal to the total number of individuals with a WIR client record for the selected age group and geographic area. For influenza vaccine, the numerators were obtained from the WIR and the denominators were obtained from population estimates from the Wisconsin Interactive Statistics on Health (WISH).

Note: All measures are based on the routine vaccination recommendations from the CDC's (Centers for Disease Control and Prevention) Advisory Committee on Immunization Practices (ACIP). The details below describe the measures on the Wisconsin Environmental Public Health Tracking Portal and should not be used as descriptions of the ACIP vaccination recommendations. For example, measuring the percentage of children who have received recommended vaccines by age 24 months is a common benchmark for evaluating the vaccination status of young children, but does not reflect or evaluate the exact ages at which each vaccine dose is recommended. For descriptions and details of the ACIP vaccination recommendations see the Child Vaccine Schedule and the Adult Vaccine Schedule.

4:3:1:3:3:1:4 - Series of seven vaccines

The 4:3:1:3:3:1:4 vaccination series is a series of seven vaccines recommended for children and includes: four or more doses of diphtheria-tetanus-acellular-pertussis (DTaP) vaccine, three or more doses of polio vaccine, one or more doses of measles, mumps, and rubella (MMR) vaccine, three or more doses of Haemophilus influenzae type b (Hib) vaccine, three or more doses of hepatitis B (HepB) vaccine, one or more doses of varicella vaccine, and four or more doses of Pneumococcal conjugate vaccine (PCV) vaccine. Percent immunized is calculated by dividing the number of children who turned 24 months and completed this vaccine series by the total number of children who turned age 24 months (by year and geographic area). Thus, the 2016 data include information on children born during 2014. (Note: Children who completed the series of seven vaccines are also found in the counts of the individual vaccine measures. For example, a child who completed the series of seven vaccines will also be counted as having completed DTaP, Polio, MMR, Hib, HepB, Varicella, and PCV vaccine measures. However, a child who received three doses of the polio vaccine and no other vaccines will be included in the Polio vaccine measure (below) but not in 4:3:1:3:3:1:4 series measure.)

DTaP vaccine (four or more doses)

Diphtheria-tetanus-acellular-pertussis (DTaP) vaccine provides protection from the diseases diphtheria, tetanus and pertussis. DTaP is for use in children. By age 24 months, children are recommended to have received four doses of DTaP vaccine. Percent immunized is calculated by dividing the number of children who turned age 24 months and had received four or more doses of DTaP by the total number of same-aged children in that year and geographic area

Hepatitis A vaccine (one or more dose)

Hepatitis A vaccine provides protection from hepatitis A. Children are recommended to receive the first dose of the hepatitis vaccine at age 1 and the second dose 6-18 months later. Percent immunized is calculated by dividing the number of children who turned age 24 months and received one or more doses of the hepatitis A vaccine by the total number of same-aged children in that year and geographic area.

Hepatitis A vaccine (up to date)

Hepatitis A vaccine provides protection from hepatitis A. Two doses of the hepatitis A vaccine are required for long-term protection and should be given after age 1. Percent immunized is calculated by dividing the number of adults who turned 18-49 years and are up-to-date on the hepatitis A vaccine by the total number of same-aged adults in that year and geographic area.

Hepatitis B vaccine (three or more doses)

Hepatitis B vaccine provides protection from hepatitis B. By age 24 months, children are recommended to have received 3 doses of hepatitis B vaccine. Percent immunized is calculated by dividing the number of children who turned age 24 months and had received three doses of the hepatitis B vaccine by the total number of same-aged children in that year and geographic area.

Hib vaccine (three or more doses)

Haemophilus influenzae type b (Hib) vaccine protects against disease caused by Hib infection. By age 24 months, children are recommended to have received three or four doses of Hib vaccine, depending on the Hib vaccine brand received. Percent immunized is calculated by dividing the number of children who turned age 24 months and had received three or more doses of Hib vaccine by the total number of same-aged children in that year and geographic area.

HPV vaccine (one or more doses)

Human papillomavirus (HPV) vaccine protects against disease caused by HPV, including HPV-related cancers. Before 2017, three doses of HPV vaccine were recommended to be considered completely vaccinated for HPV. To assess the initiation of HPV vaccination, this measure assesses the percent of individuals who received one or more doses of HPV vaccine. Percent immunized is calculated by dividing the number of children who turned age 13-18 years and had received one or more doses of HPV vaccine by the total number of same-aged adolescents in that year and geographic area.

HPV complete vaccine

Human papillomavirus (HPV) vaccine protects against disease caused by HPV, including HPV-related cancers. Before 2017, three doses of HPV vaccine were recommended to be considered completely vaccinated for HPV. To assess the completion of HPV vaccination, this measure assesses the percent of individuals who received two or three doses of HPV vaccine depending on their age at series initiation (two doses if age 9-14 at initial vaccination, and three doses if age 15+ at initial vaccination). Percent immunized is calculated by dividing the number of children who turned age 13-18 years or 19-26 years and had received the complete number of HPV vaccine doses by the total number of same-aged adolescents in that year and geographic area.

Influenza vaccine protects against influenza disease, commonly called the flu. Every influenza season (approximately August through June) all individuals age 6 months and older are recommended to receive influenza vaccine. Percent immunized is calculated by dividing the number of people who received one or more doses of influenza vaccine during the selected influenza season by the total number of same-aged people in the selected season, year, and geographic region.

MenACWY (Meningitis) vaccine (1+ doses)

Meningococcal conjugate vaccine ACWY (MenACWY) protects against disease caused by bacteria Neisseria meningitides serogroups A, C, W, and Y. Adolescents are recommended to receive MenACWY vaccine at age 11-12 and a booster dose at age 16 years. However, if the first dose is received at age 16 or older, no booster dose is needed. To assess the initiation of MenACWY vaccination, this measure assesses the percent of individuals who received one or more doses of the MenACWY vaccine. Percent immunized is calculated by dividing the number of individuals aged 13-18 years who received one or more doses of the MenACWY vaccine by the total number of same-aged individuals in the selected year and geographic area.

MenACWY (Meningitis) vaccine (up-to-date)

Meningococcal conjugate vaccine ACWY (MenACWY) protects against disease caused by bacteria Neisseria meningitides serogroups A, C, W, and Y. Adolescents are recommended to receive MenACWY vaccine at age 11-12 and a booster dose at age 16 years. However, if the first dose is received at age 16 or older, no booster dose is needed. To assess the completion of MenACWY vaccination, this measure assesses the number of individuals who were up-to-date (had received a booster dose or a first dose at age 16 years or older) with MenACWY vaccine. Percent immunized is calculated by dividing the number of individuals aged 17-18 years who were up-to-date with the MenACWY vaccine by the total number of same-aged individuals in the selected year and geographic area.

MMR vaccine (one or more doses)

Measles, mumps, and rubella (MMR) vaccine protects against the diseases measles, mumps, and rubella. By age 24 months, children are recommended to have received one dose of MMR vaccine. Percent immunized is calculated by dividing the number of children who turned age 24 months and had received one or more doses of MMR vaccine by the total number of same-aged children in that year and geographic area.

PCV Vaccine (four or more doses)

Pneumococcal conjugate vaccine (PCV) protects against diseases caused by Streptococcus pneumoniae bacteria. Before 2010, the only PCV vaccine that was available was PCV7, which protects against 7 serotypes of S. pneumoniae. In 2010, PCV13 vaccine was introduced and protects against 13 serotypes S. pneumoniae. Children assessed during the earliest years displayed for this measure might have received either PCV7 or PCV13 or both. By age 24 months, children are recommended to have received four doses of PCV vaccine. Percent immunized is calculated by dividing the number of children who turned age 24 months and had received 4 or more doses of PCV vaccine by the total number of same-aged children in that year and geographic area

PCV13 vaccine (one or more doses)

Pneumococcal conjugate vaccine (PCV13) protects against disease caused by 13 serotypes of Streptococcus pneumoniae. One dose of PCV13 vaccine is recommended for all adults aged 65 years and older. Percent immunized is calculated by dividing the number of adults who received one or more doses of the PCV13 vaccine on or after their 65th birthday by the total number of same-aged adults in that year and geographic area.

PPSV23 vaccine (one or more doses)

Pneumococcal polysaccharide vaccine (PPSV23) protects against disease caused by 23 serotypes of Streptococcus pneumoniae bacteria. One dose of PPSV23 vaccine is routinely recommended for adults age 65 and older. Percent immunized is calculated by dividing the number of adults who received one or more doses of the PPSV23 vaccine on or after their 65th birthday by the total number of same-aged adults in that year and geographic area.

Polio vaccine (three or more doses)

Polio vaccine protects against polio. By age 24 months, children are recommended to have received three doses of polio vaccine. Percent immunized is calculated by dividing the number of children who turned age 24 months and had received three or more doses of polio vaccine by the total number of same-aged children in that year and geographic area.

Tdap vaccine (one or more doses)

Tetanus-diphtheria-acellular-pertussis (Tdap) vaccine provides protection from the diseases diphtheria, tetanus and pertussis. Tdap is for use in adolescents and adults: one dose is recommended during a lifetime (except for pregnant women who are recommended to receive Tdap during every pregnancy). Percent immunized is calculated by dividing the number of individuals who turned age 13-18 years or age 19-64 years who had received one or more doses of Tdap by the total number of same-aged individuals in that year and geographic area.

Varicella Vaccine (one or more doses)

Varicella vaccine protects against chickenpox disease. By age 24 months, children are recommended to have received one dose of varicella vaccine. Percent immunized is calculated by dividing the number of children who turned age 24 months and who received one or more doses of varicella vaccine by the total number of same-aged children in that year and geographic area.

Zoster vaccine (one or more doses)

Zoster vaccine protects against herpes zoster (shingles) disease. Previously, one dose of zoster vaccine was recommended for adults aged 60 years and older. At the end of 2017, the Advisory Committee on Immunization Practice changed the zoster recommendation to two doses of zoster vaccine (Zoster complete) for individuals aged 50 years and older, regardless of prior zoster vaccine receipt. As such, the data presented here reflect this artifact of the change in definition. Before 2018, percent immunized was calculated by dividing the number of adults aged 60 years or older who received one or more doses of zoster vaccine by the total number of same-aged adults in that year and geographic area. With Zoster complete, percent immunized is calculated by dividing the number of adults aged 50 years or older who received both doses of zoster vaccine by the total number of same-aged adults in that year and geographic area.

Explore definitions and explanations of terminology found on the portal, like age-adjusted rate and confidence intervals.