Focus Area 14: Immunization and Infectious Diseases: Objectives and Subobjectives

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

Diseases Preventable Through Universal Vaccination

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

14-1.

Reduce or eliminate indigenous cases of vaccine-preventable diseases.

Target and baseline:

Objective	Reduction in Vaccine-Preventable Diseases	1998 Baseline (unless noted) Number of Cases	2010 Target Number of Cases
14-1a.	Congenital rubella syndrome (children under age 1 year)	7	0
14-1b.	Diphtheria (persons under age 35 years)	1	0
14-1c.	Haemophilus influenzae type b* (children under age 5 years)	163	0
14-1d.	Hepatitis B (persons aged 2 to 18 years)	708^†1	7²
14-1e.	Measles (persons of all ages)	74	0
14-1f.	Mumps (persons of all ages)	666	0
14-1g.	Pertussis (children under age 7 years)	3,417	2,000
14-1h.	Polio (wild-type virus) (persons of all ages)	0	0
14-1i.	Rubella (persons of all ages)	364	0
14-1j.	Tetanus (persons under age 35 years)	14	0
14-1k.	Varicella (chicken pox) (persons aged 17 years and under)	2,228,000 (1999)^‡3	223,000⁴

* Includes cases with type b and unknown serotype.
† Estimated hepatitis B cases for 1997.
‡ Data based on average from 1999 for persons of all ages.

Target setting method: Total elimination for congenital rubella syndrome, diphtheria, Haemophilus influenzae type b, measles, mumps, polio, rubella, and tetanus; 41 percent improvement for pertussis; 99 percent improvement for hepatitis B and varicella.

Data sources: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO; National Congenital Rubella Syndrome Registry (NCRSR), CDC, NIP—congenital rubella syndrome; Active Bacterial Core Surveillance (ABCs), Emerging Infections Programs, CDC, NCID—Haemophilus influenzae type b; National Health Interview Survey (NHIS), CDC, NCHS—varicella.

¹ Baseline revised from 945 after November 2000 publication.
² Target revised from 9 because of baseline revision after November 2000 publication.
³ Baseline and baseline year revised from 4 million and 1990–94 after November 2000 publication.
⁴ Target revised from 400,000 because of baseline revision after November 2000 publication.

NO CHANGE IN OBJECTIVE

14-2.

Reduce chronic hepatitis B virus infections in infants and young children (perinatal infections).

Target: 400 infections.

Baseline: 1,682 chronic hepatitis B virus infections in infants and children aged 2 years and under were reported in 1995.

Target setting method: 76 percent improvement.

Data sources: Perinatal Hepatitis B Prevention Program, CDC, NCID; National Vital Statistics System (NVSS), CDC, NCHS; State Perinatal Hepatitis B Prevention Programs; State Vital Statistics Systems.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

14-3.

Reduce hepatitis B.

Target and baseline:

Objective	Reduction in Hepatitis B	1997 Baseline Rate per 100,000 Population	2010 Target Rate per 100,000 Population
	Adults
14-3a.	19 to 24 years	18.5¹	1.8²
14-3b.	25 to 39 years	20.5³	5.2⁴
14-3c.	40 years and older	14.7⁵	3.7⁶
	High-risk groups	Number of Cases	Number of Cases
14-3d.	Injection drug users	7,135⁷	1,784⁸
14-3e.	Heterosexually active persons	15,021⁹	1,223¹⁰
14-3f.	Men who have sex with men	5,209¹¹	1,302¹²
14-3g.	Occupationally exposed workers	239¹³	60¹⁴

Target setting method: For 14-3a, 14-3b, and 14-3c, better than the best; for 14-3d, 14-3f, and 14-3g, 75 percent improvement; for 14-3e, 92 percent improvement.

Data sources: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO; Sentinel Counties Study of Viral Hepatitis, CDC, NCID.

¹ Baseline revised from 24.0 after November 2000 publication.
² Target revised from 2.4 because of baseline revision after November 2000 publication.
³ Baseline revised from 20.2 after November 2000 publication.
⁴ Target revised from 5.1 because of baseline revision after November 2000 publication.
⁵ Baseline revised from 15.0 after November 2000 publication.
⁶ Target revised from 3.8 because of baseline revision after November 2000 publication.
⁷ Baseline revised from 7,232 after November 2000 publication.
⁸ Target revised from 1,808 because of baseline revision after November 2000 publication.
⁹ Baseline revised from 15,225 after November 2000 publication.
¹⁰ Target revised from 1,240 because of baseline revision after November 2000 publication.
¹¹ Baseline revised from 7,232 after November 2000 publication.
¹² Target revised from 1,808 because of baseline revision after November 2000 publication.
¹³ Baseline revised from 249 after November 2000 publication.
¹⁴ Target revised from 62 because of baseline revision after November 2000 publication.

NO CHANGE IN OBJECTIVE

14-4.

Reduce bacterial meningitis in young children.

Target: 8.6 new cases per 100,000 children aged 1 through 23 months.

Baseline: 13.0 new cases of bacterial meningitis per 100,000 children aged 1 through 23 months were reported in 1998.

Target setting method: 34 percent improvement. (Better than the best will be used when data are available.)

Data source: Active Bacterial Core Surveillance (ABCs), Emerging Infections Program Network, CDC, NCID.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

14-5.

Reduce invasive pneumococcal infections.

Target and baseline:

Objective	Reduction in Invasive Pneumococcal Infections	1997 Baseline Rate per 100,000	2010 Target Rate per 100,000
	New invasive pneumococcal infections
14-5a.	Children under age 5 years	77¹	46²
14-5b.	Adults aged 65 years and older	62	42
	Invasive penicillin-resistant pneumococcal infections
14-5c.	Children under age 5 years	16	6
14-5d.	Adults aged 65 years and older	8³	7⁴

Target setting method: Better than the best.

Data sources: Active Bacterial Core Surveillance (ABCs), Emerging Infections Program Network, CDC, NCID; Arctic Investigations Program (for data on pneumococcal disease rates among Alaska Natives), CDC.

¹Baseline revised from 76 after November 2000 publication.
² Target revised from 46 because of baseline revision after November 2000 publication.
³ Baseline revised from 9 after November 2000 publication.
⁴ Target revised from 7 because of baseline revision after November 2000 publication.

Diseases Preventable Through Targeted Vaccination

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

14-6.

Reduce hepatitis A.

Target: 4.3¹ new cases per 100,000 population.

Baseline: 11.2² new cases of hepatitis A per 100,000 population were reported in 1997.

Target setting method: Better than the best.

Data source: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO.

¹ Target revised from 4.5 because of baseline revision after November 2000 publication.
² Baseline revised from 11.3 after November 2000 publication.

NO CHANGE IN OBJECTIVE

14-7.

Reduce meningococcal disease.

Target: 1.0 new cases per 100,000 population.

Baseline: 1.3 new cases of meningococcal disease per 100,000 population were reported in 1997.

Target setting method: Better than the best.

Data sources: Active Bacterial Core Surveillance (ABCs), Emerging Infections Program Network, CDC, NCID; National Notifiable Diseases Surveillance System (NNDSS), CDC, EPO.

Infectious Diseases and Emerging Antimicrobial Resistance

NO CHANGE IN OBJECTIVE
14-8.	Reduce Lyme disease. Target: 9.7 new cases per 100,000 population in endemic States. Baseline: 17.4 new cases of Lyme disease per 100,000 population were reported in 1992–96. Target setting method: 44 percent improvement. (Better than the best will be used when data are available.) Potential data source: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

14-9.

Reduce hepatitis C.

Target: 1.0 new cases per 100,000 population.

Baseline: 2.5¹ new cases of hepatitis C per 100,000 population in selected counties were reported in 1997.^{1, 2}

Target setting method: Better than the best.

Data source: Sentinel Counties Study of Viral Hepatitis, CDC, NCID.

¹ Baseline and baseline year revised from 2.4 and 1996 after November 2000 publication.
² Baseline data are from selected counties, all other data are based on national reporting.

ORIGINAL OBJECTIVE
14-10.	(Developmental) Increase the proportion of persons with chronic hepatitis C infection identified by State and local health departments. Potential data sources: State health department databases of persons with HCV infection; National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
OBJECTIVE WITH REVISIONS
14-10.	(Developmental) Increase the ~~proportion of persons with~~number of States and the District of Columbia identifying persons with chronic hepatitis C infection ~~identified by State and local health departments~~. Potential data sources: National Notifiable Disease Surveillance System (NNDSS), ~~State health department databases of persons with HCV infection; National Health~~ ~~and Nutrition Examination Survey (NHANES),~~ CDC, EOP~~NCHS~~.
REVISED OBJECTIVE
14-10.	(Developmental) Increase the number of States and the District of Columbia identifying persons with chronic hepatitis C infection. Potential data source: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO.

NO CHANGE IN OBJECTIVE
14-11.	Reduce tuberculosis. Target: 1.0 new cases per 100,000 population. Baseline: 6.8 new cases of tuberculosis per 100,000 population were reported in 1998. Target setting method: Better than the best. Data source: National TB Surveillance System, CDC, NCHSTP.

NO CHANGE IN OBJECTIVE
14-12.	Increase the proportion of all tuberculosis patients who complete curative therapy within 12 months. Target: 90 percent of patients. Baseline: 74 percent of those tuberculosis patients reported in 1996 and started on therapy completed therapy within 12 months. Target setting method: Better than the best. Data source: National TB Surveillance System, CDC, NCHSTP.

ORIGINAL OBJECTIVE
14-13.	Increase the proportion of contacts and other high-risk persons with latent tuberculosis infection who complete a course of treatment. Target: 85 percent. Baseline: 62 percent of tuberculosis contacts and other high-risk persons who started on treatment for latent TB infection in 1997 completed treatment. Target setting method: 27 percent improvement. (Better than the best will be used when data are available.) Data source: Aggregate Reports for TB Reports Evaluation, CDC, NCHSTP.
OBJECTIVE WITH REVISIONS
14-13.	Increase the proportion of ~~contacts and other high-risk~~ persons with latent tuberculosis infection who complete a course of treatment. Target: 8557 percent. Baseline: 4562 percent of ~~tuberculosis contacts and other high-risk~~ persons ~~who~~ ~~started on treatment~~ with latent TB infection in ~~1997~~ 2000 completed treatment. Target setting method: 27 percent improvement. (Better than the best will be used when data are available.) Data source: Aggregate Reports for TB Reports Evaluation, CDC, NCHSTP.
REVISED OBJECTIVE
14-13.	Increase the proportion of persons with latent tuberculosis infection who complete a course of treatment. Target: 57 percent. Baseline: 45 percent of persons with latent TB infection in 2000 completed treatment. Target setting method: 27 percent improvement. (Better than the best will be used when data are available.) Data source: Aggregate Reports for TB Reports Evaluation, CDC, NCHSTP.

NO CHANGE IN OBJECTIVE
14-14.	Reduce the average time for a laboratory to confirm and report tuberculosis cases. Target: 2 days for 75 percent of cases. Baseline: 21 days were needed for a laboratory to confirm and report 75 percent of TB cases in 1996. Target setting method: 90 percent improvement. Data source: Survey of State Public Health Laboratories, CDC, NCHSTP.

OBJECTIVE DELETED
14-15.	(Objective deleted due to lack of data source) (Developmental) Increase the proportion of international travelers who receive recommended preventive services when traveling in areas of risk for select infectious diseases: hepatitis A, malaria, and typhoid.

NO CHANGE IN OBJECTIVE
14-16.	Reduce invasive early onset group B streptococcal disease. Target: 0.5 new cases per 1,000 live births. Baseline: 1.0 new case of invasive early onset group B streptococcal disease per 1,000 live births was reported in 1996. Target setting method: Better than the best. Data source: Active Bacterial Core Surveillance (ABCs), Emerging Infections Program Network, CDC, NCID.

NO CHANGE IN OBJECTIVE
14-17.	Reduce hospitalizations caused by peptic ulcer disease in the United States. Target: 46 hospitalizations per 100,000 population. Baseline: 71 hospitalizations per 100,000 population occurred in 1998 (age adjusted to the year 2000 standard population). Target setting method: Better than the best. Data sources: National Hospital Discharge Survey (NHDS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

14-18.

Reduce the number of courses of antibiotics for ear infections for young children.

Target: 56¹ antibiotic courses per 100 children under age 5 years.

Baseline: 69² antibiotic courses for otitis media per 100 children under age 5 years were prescribed during 1996–97 (2-year average).

Target setting method: 19 percent improvement.

Data sources: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS; National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

¹ Target revised from 88 because of baseline revision after November 2000 publication.
² Baseline revised from 108 after November 2000 publication.

NO CHANGE IN OBJECTIVE

14-19.

Reduce the number of courses of antibiotics prescribed for the sole diagnosis of the common cold.

Target: 1,268 antibiotic courses per 100,000 population.

Baseline: 2,535 antibiotic courses per 100,000 population were prescribed for the sole diagnosis of the common cold, 1996–97.

Target setting method: 50 percent improvement.

Data sources: National Ambulatory Medical Care Survey (NAMCS), CDC, NCHS; National Hospital Ambulatory Medical Care Survey (NHAMCS), CDC, NCHS.

ORIGINAL OBJECTIVE

14-20.

Reduce hospital-acquired infections in intensive care unit patients.

Target and baseline:

Objective	Reduction in Hospital-Acquired Infections in Intensive Care Units	1998 Baseline Infections per 1,000 Days’ Use	2010 Target Infections per 1,000 Days’ Use
	Intensive care unit patients
14-20a.	Catheter-associated urinary tract infection	5.5¹	5.0²
14-20b.	Central line-associated bloodstream infection	5.5³	5.0⁴
14-20c.	Ventilator-associated pneumonia	11.1	10.0
	Infants weighing 1,000 grams or less at birth in intensive care
14-20d.	Central line-associated bloodstream infection	12.2	11.0
14-20e.	Ventilator-associated pneumonia	4.9	4.4

Target setting method: 10 percent improvement. (Better than the best will be used when data are available.)

Data source: National Nosocomial Infections Surveillance System (NNIS), CDC, NCID.

¹Baseline revised from 5.9 after November 2000 publication.
² Target revised from 5.3 because of baseline revision after November 2000 publication.
³ Baseline revised from 5.3 after November 2000 publication.
⁴ Target revised from 4.8 because of baseline revision after November 2000 publication.

OBJECTIVE WITH REVISIONS

14-20.

Reduce hospital-acquired infections in intensive care unit patients.

Target and baseline:

Objective	Reduction in Hospital-Acquired Infections in Intensive Care Units	1998 Baseline (unless noted) Infections per 1,000 Days’ Use	2010 Target Infections per 1,000 Days’ Use
	Adult and pediatric intensive care unit patients
14-20a.	Catheter-associated urinary tract infection	5.5¹	5.0²
14-20b.	Central line-associated bloodstream infection	5.5³	5.0⁴
14-20c.	Ventilator-associated pneumonia	~~11.1~~ 5.9 (2002–03)	~~10.0~~ 5.3
	Infants weighing 1,000 grams or less at birth in intensive care
14-20d.	Central line-associated bloodstream infection	12.2	11.0
14-20e.	Ventilator-associated pneumonia	~~4.9~~ 3.0 (2002–03)	~~4.4~~ 2.7

Target setting method: 10 percent improvement. (Better than the best will be used when data are available.)

Data source: National Nosocomial Infections Surveillance System (NNIS), CDC, NCID.

¹ Baseline revised from 5.9 after November 2000 publication.
² Target revised from 5.3 because of baseline revision after November 2000 publication.
³ Baseline revised from 5.3 after November 2000 publication.
⁴ Target revised from 4.8 because of baseline revision after November 2000 publication.

REVISED OBJECTIVE

14-20.

Reduce hospital-acquired infections in intensive care unit patients.

Target and baseline:

Objective	Reduction in Hospital-Acquired Infections in Intensive Care Units	1998 Baseline (unless noted) Infections per 1,000 Days’ Use	2010 Target Infections per 1,000 Days’ Use
	Adult and pediatric intensive care unit patients
14-20a.	Catheter-associated urinary tract infection	5.5¹	5.0²
14-20b.	Central line-associated bloodstream infection	5.5³	5.0⁴
14-20c.	Ventilator-associated pneumonia	5.9 (2002–03)	5.3
	Infants weighing 1,000 grams or less at birth in intensive care
14-20d.	Central line-associated bloodstream infection	12.2	11.0
14-20e.	Ventilator-associated pneumonia	3.0 (2002–03)	2.7

Target setting method: 10 percent improvement. (Better than the best will be used when data are available.)

Data source: National Nosocomial Infections Surveillance System (NNIS), CDC, NCID.

¹Baseline revised from 5.9 after November 2000 publication.
²Target revised from 5.3 because of baseline revision after November 2000 publication.
³ Baseline revised from 5.3 after November 2000 publication.
⁴Target revised from 4.8 because of baseline revision after November 2000 publication.

ORIGINAL OBJECTIVE
14-21.	Reduce antimicrobial use among intensive care unit patients. Target: 120 daily doses per 1,000 patient days. Baseline: 150 daily doses of antimicrobials per 1,000 patient days were used among intensive care unit patients in 1995. Target setting method: 20 percent improvement. Data source: National Nosocomial Infections Surveillance System (NNIS), CDC, NCID.
OBJECTIVE WITH REVISIONS
14-21.	Reduce ~~antimicrobial~~ vancomycin use among intensive care unit patients. Target: ~~120~~ 85.1 doses per 1,000 patient days. Baseline: ~~150~~106.4 doses of vancomycin per 1,000 patient days were used among intensive care unit patients in ~~1995~~1998–2003. Target setting method: 20 percent improvement. Data source: National Nosocomial Infections Surveillance System (NNIS), CDC, NCID.
REVISED OBJECTIVE
14-21.	Reduce vancomycin use among intensive care unit patients. Target: 85.1 doses per 1,000 patient days. Baseline: 106.4 doses of vancomycin per 1,000 patient days were used among intensive care unit patients in 1998–2003. Target setting method: 20 percent improvement. Data source: National Nosocomial Infections Surveillance System (NNIS), CDC, NCID.

Vaccination Coverage and Strategies

ORIGINAL OBJECTIVE

14-22.

Achieve and maintain effective vaccination coverage levels for universally recommended vaccines among young children.

Target and baseline:

Objective	Increase in and Maintenance of Vaccination Coverage Levels Among Children Aged 19 to 35 Months	1998 Baseline Percent	2010 Target Percent
14-22a.	4 doses diphtheria-tetanus-acellular pertussis (DTaP) vaccine	84	90
14-22b.	3 doses Haemophilus influenzae type b (Hib) vaccine	93	90
14-22c.	3 doses hepatitis B (hep B) vaccine	87	90
14-22d.	1 dose measles-mumps-rubella (MMR) vaccine	92	90
14-22e.	3 doses polio vaccine	91	90
14-22f.	1 dose varicella vaccine	43	90

Target setting method: Consistent with the Childhood Immunization Initiative.

Data source: National Immunization Survey (NIS), CDC, NCHS and NIP.

OBJECTIVE WITH REVISIONS

14-22.

Achieve and maintain effective vaccination coverage levels for universally recommended vaccines among young children.

Target and baseline:

Objective	Increase in and Maintenance of Vaccination Coverage Levels Among Children Aged 19 to 35 Months	1998 Baseline (unless noted) Percent	2010 Target Percent
14-22a.	4 doses diphtheria-tetanus-acellular pertussis (DTaP) vaccine	84	90
14-22b.	3 doses Haemophilus influenzae type b (Hib) vaccine	93	90
14-22c.	3 doses hepatitis B (hep B) vaccine	87	90
14-22d.	1 dose measles-mumps-rubella (MMR) vaccine	92	90
14-22e.	3 doses polio vaccine	91	90
14-22f.	1 dose varicella vaccine	43	90
14-22g.	4 doses pneumococcal conjugate vaccine	20 (2002)	90
14-22h.	1 dose influenza vaccine (aged 6 to 23 months)	Developmental	Developmental

Target setting method: Consistent with the Childhood Immunization Initiative.

Data source: National Immunization Survey (NIS), CDC, NCHS and NIP.

REVISED OBJECTIVE

14-22.

Achieve and maintain effective vaccination coverage levels for universally recommended vaccines among young children.

Target and baseline:

Objective	Increase in and Maintenance of Vaccination Coverage Levels Among Children Aged 19 to 35 Months	1998 Baseline (unless noted) Percent	2010 Target Percent
14-22a.	4 doses diphtheria-tetanus-acellular pertussis (DTaP) vaccine	84	90
14-22b.	3 doses Haemophilus influenzae type b (Hib) vaccine	93	90
14-22c.	3 doses hepatitis B (hep B) vaccine	87	90
14-22d.	1 dose measles-mumps-rubella (MMR) vaccine	92	90
14-22e.	3 doses polio vaccine	91	90
14-22f.	1 dose varicella vaccine	43	90
14-22g.	4 doses pneumococcal conjugate vaccine	20 (2002)	90
14-22h.	1 dose influenza vaccine (aged 6 to 23 months)	Developmental	Developmental

Target setting method: Consistent with the Childhood Immunization Initiative.

Data source: National Immunization Survey (NIS), CDC, NCHS and NIP.

ORIGINAL OBJECTIVE

14-23.

Maintain vaccination coverage levels for children in licensed day care facilities and children in kindergarten through the first grade.

Target and baseline:

Objective	Maintenance of Vaccination Coverage Levels for Children	1997–98 Baseline* Percent	2010 Target Percent
	Children in day care
14-23a.	Diphtheria-tetanus-acellular pertussis (DTaP) vaccine	96	95
14-23b.	Measles/mumps/rubella vaccines	89	95
14-23c.	Polio vaccine	96	95
14-23d.	Hepatitis B vaccine	Developmental	Developmental
14-23e.	Varicella vaccine	Developmental	Developmental
	Children in K through 1st grade
14-23f.	Diphtheria-tetanus-acellular pertussis (DTaP) vaccine	97	95
14-23g.	Measles/mumps/rubella vaccines	96	95
14-23h.	Polio vaccine	97	95
14-23i.	Hepatitis B vaccine	Developmental	Developmental
14-23j.	Varicella vaccine	Developmental	Developmental

* Weighted means.

Target setting method: Consistent with year 2000 target. (Better than the best will be used when data are available.)

Data source: Immunization Program Annual Reports, CDC, NIP.

OBJECTIVE WITH REVISIONS

14-23.

Maintain vaccination coverage levels for children in licensed day care facilities and children in kindergarten ~~through first grade~~.

Target and baseline:

Objective*	Maintenance of Vaccination Coverage Levels for Children	1997–98 Baseline^† (unless noted) Percent*	2010 Target Percent
	Children in day care
14-23a.	Diphtheria-tetanus-acellular pertussis (DTaP) vaccine	96	95
14-23b.	Measles/mumps/rubella vaccines	89	95
14-23c.	Polio vaccine	96	95
14-23d.	Hepatitis B vaccine	93 (2003–04) ~~Developmental~~	95
14-23e.	Varicella vaccine	87 (2003–04) ~~Developmental~~	95
	Children in kindergarten
14-23f.	Diphtheria-tetanus-acellular pertussis (DTaP) vaccine	9795 (2002–03)	95
14-23g.	Measles/mumps/rubella vaccines	96 (2002–03)	95
14-23h.	Polio vaccine	976 (2002–03)	95
14-23i.	Hepatitis B vaccine	96 (2002–03) ~~Developmental~~	95
14-23j.	Varicella vaccine	93 (2002–03) ~~Developmental~~	95
	Children in day care
14-23k.*	Pneumococcal conjugate vaccine	53 (2003–04)	95
14-23l.*	Haemophilus influenzae type b vaccine	94 (2003–04)	90

* For data control purposes, subobjectives are not renumbered.
^† Weighted means.

Target setting method: Consistent with year 2000 target. (Better than the best will be used when data are available.)

Data source: Immunization Program Annual Reports, CDC, NIP.

REVISED OBJECTIVE

14-23.

Maintain vaccination coverage levels for children in licensed day care facilities and children in kindergarten.

Target and baseline:

Objective*	Maintenance of Vaccination Coverage Levels for Children	1997–98 Baseline^† (unless noted) Percent	2010 Target Percent
	Children in day care
14-23a.	Diphtheria-tetanus-acellular pertussis (DTaP) vaccine	96	95
14-23b.	Measles/mumps/rubella vaccines	89	95
14-23c.	Polio vaccine	96	95
14-23d.	Hepatitis B vaccine	93 (2003–04)	95
14-23e.	Varicella vaccine	87 (2003–04)	95
	Children in kindergarten
14-23f.	Diphtheria-tetanus-acellular pertussis (DTaP) vaccine	95 (2002–03)	95
14-23g.	Measles/mumps/rubella vaccines	96 (2002–03)	95
14-23h.	Polio vaccine	96 (2002–03)	95
14-23i.	Hepatitis B vaccine	96 (2002–03)	95
14-23j.	Varicella vaccine	93 (2002–03)	95
	Children in day care
14-23k.*	Pneumococcal conjugate vaccine	53 (2003–04)	95
14-23l.*	Haemophilus influenzae type b vaccine	94 (2003-04)	90

NO CHANGE IN OBJECTIVE

14-24.

Increase the proportion of young children and adolescents who receive all vaccines that have been recommended for universal administration for at least 5 years.

Target and baseline:

Objective	Increase in Coverage Levels of Universally Recommended Vaccines	1998 Baseline Percent	2010 Target Percent
14-24a.	Children aged 19 to 35 months who receive the recommended vaccines (4 DTaP, 3 polio, 1 MMR, 3 Hib, 3 hep B)	73	80
14-24b.	Adolescents aged 13 to 15 years who receive the recommended vaccines	Developmental	Developmental

Target setting method: Better than the best.

Data source: National Immunization Survey (NIS), CDC, NCHS and NIP; National Health Interview Survey (NHIS), CDC, NCHS.

ORIGINAL OBJECTIVE

14-25.

Increase the proportion of providers who have measured the vaccination coverage levels among children in their practice population within the past 2 years.

Target and baseline:

Objective	Increase in Providers Measuring Vaccination Levels	1997 Baseline Percent	2010 Target Percent
14-25a.	Public health providers	66	90
14-25b.	Private providers	6	90

Target setting method: 36 percent improvement for public health providers; 1,400 percent improvement for private providers.

Data source: Immunization Program Annual Reports, CDC, NIP.

OBJECTIVE WITH REVISIONS

14-25.

Increase the proportion of providers who have had vaccination coverage levels among children in their practice population ~~have~~ measured ~~the vaccination~~ ~~coverage levels among children in their practice population~~ within the past 2 years.

Target and baseline:

Objective	Increase in Providers Measuring Vaccination Levels	19979 Baseline Percent	2010 Target Percent
14-25a.	Public health providers	6640	9055
14-25b.	Private providers	611	9055

Target setting method: 36 percent improvement for public health providers;~~1,400~~ 391 percent improvement for private providers.

Data source: Immunization Program Annual Reports, CDC, NIP.

REVISED OBJECTIVE

14-25.

Increase the proportion of providers who have had vaccination coverage levels among children in their practice population measured within the past 2 years.

Target and baseline:

Objective	Increase in Providers Measuring Vaccination Levels	1999 Baseline Percent	2010 Target Percent
14-25a.	Public health providers	40	55
14-25b.	Private providers	11	55

Target setting method: 36 percent improvement for public health providers; 391 percent improvement for private providers.

Data source: Immunization Program Annual Reports, CDC, NIP.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

14-26.

Increase the proportion of children who participate in fully operational population-based immunization registries.

Target: 62¹ percent of children under age 6 years.

Baseline: 21² percent of children under age 6 years participated in an immunization registry in 1999.

Target setting method: 197 percent improvement. (Better than the best will be used when data are available.)

Data source: Immunization Program Annual Reports, CDC, NIP.

¹ Target revised from 95 because of baseline revision after November 2000 publication.
² Baseline revised from 32 after November 2000 publication.

NO CHANGE IN OBJECTIVE

14-27.

Increase routine vaccination coverage levels for adolescents.

Target and baseline:

Objective	Increase in Vaccination Coverage Levels for Adolescents Aged 13 to 15 Years	1997 Baseline* Percent	2010 Target Percent
14-27a.	3 or more doses of hepatitis B	48	90
14-27b.	2 or more doses of measles, mumps, rubella	89	90
14-27c.	1 or more doses of tetanus-diphtheria booster	93	90
14-27d.	1 or more doses of varicella (excluding children who have had varicella)	45	90

* Data are based primarily on parental recall; provider verification has not occurred.

Target setting method: Consistent with target levels established under the Childhood Immunization Initiative.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

14-28.

Increase hepatitis B vaccine coverage among high-risk groups.

Target and baseline:

Objective	Increase in Hepatitis B Vaccine Coverage in High-Risk Groups	1995 Baseline Percent	2010 Target Percent
14-28a.	Long-term hemodialysis patients	35	90
14-28b.	Men who have sex with men	9	60
14-28c.	Occupationally exposed workers	67¹	93²

Target setting method: 157 percent improvement for long-term hemodialysis patients; 567 percent improvement for men who have sex with men; 38 percent improvement for occupationally exposed workers.

Data sources: Young Men’s Survey, CDC, NCHSTP; Annual Survey of Chronic Hemodialysis Centers, CDC, NCID, and CMS; periodic vaccine coverage surveys, CDC, NCID.

¹ Baseline revised from 71 after November 2000 publication.
² Target revised from 98 because of baseline revision after November 2000 publication.

ORIGINAL OBJECTIVE

14-29.

Increase the proportion of adults who are vaccinated annually against influenza and ever vaccinated against pneumococcal disease.

Target and baseline:

Objective	Increase in Adults Vaccinated	1998 Baseline* (unless noted) Percent	2010 Target Percent
	Noninstitutionalized adults aged 65 years and older
14-29a.	Influenza vaccine	64	90
14-29b.	Pneumococcal vaccine	46	90
	Noninstitutionalized high-risk adults aged 18 to 64 years
14-29c.	Influenza vaccine	26	60
14-29d.	Pneumococcal vaccine	13	60
	Institutionalized adults (persons in long-term or nursing homes)^†
14-29e.	Influenza vaccine	59 (1997)	90
14-29f.	Pneumococcal vaccine	25 (1997)	90

* Age adjusted to the year 2000 standard population.
^† National Nursing Home Survey estimates include a significant number of residents who have an unknown vaccination status. See Tracking Healthy People 2010 for further discussion of the data issues.

Target setting method: Better than the best.

Data sources: National Health Interview Survey (NHIS), CDC, NCHS—noninstitutionalized populations; National Nursing Home Survey (NNHS), CDC, NCHS—institutionalized populations.

OBJECTIVE WITH REVISIONS

14-29.

Increase the proportion of adults who are vaccinated annually against influenza and ever vaccinated against pneumococcal disease.

Target and baseline:

Objective	Increase in Adults Vaccinated	1998 Baseline* (unless noted) Percent	2010 Target Percent
	Noninstitutionalized adults aged 65 years and older
14-29a.	Influenza vaccine	64	90
14-29b.	Pneumococcal vaccine	46	90
	Noninstitutionalized high-risk adults aged 18 to 64 years
14-29c.	Influenza vaccine	26	60
14-29d.	Pneumococcal vaccine	13	60
	Institutionalized adults (persons aged 18 years and older in long-term or nursing homes)^†
14-29e.	Influenza vaccine	59 (1997)	90
14-29f.	Pneumococcal vaccine	25 (1997)	90
	Noninstitutionalized adults aged 18 to 64 years
14-29g.	Influenza vaccine for health care workers	37 (2000)	60

REVISED OBJECTIVE

14-29.

Increase the proportion of adults who are vaccinated annually against influenza and ever vaccinated against pneumococcal disease.

Target and baseline:

Objective	Increase in Adults Vaccinated	1998 Baseline* (unless noted) Percent	2010 Target Percent
	Noninstitutionalized adults aged 65 years and older
14-29a.	Influenza vaccine	64	90
14-29b.	Pneumococcal vaccine	46	90
	Noninstitutionalized high-risk adults aged 18 to 64 years
14-29c.	Influenza vaccine	26	60
14-29d.	Pneumococcal vaccine	13	60
	Institutionalized adults (persons aged 18 years and older in long-term or nursing homes)^†
14-29e.	Influenza vaccine	59 (1997)	90
14-29f.	Pneumococcal vaccine	25 (1997)	90
	Noninstitutionalized adults aged 18 to 64 years
14-29g.	Influenza vaccine for health care workers	37 (2000)	60

Vaccine Safety

NO CHANGE IN OBJECTIVE

14-30.

14-30a.

14-30b.

Reduce vaccine-associated adverse events.

Eliminate vaccine-associated paralytic polio (VAPP).

Target: Zero cases.

Baseline: 5 VAPP cases occurred in 1997.

Target setting method: Total elimination.

Data source: National Notifiable Disease Surveillance System (NNDSS), CDC, EPO.

Reduce febrile seizures following pertussis vaccines.

Target: 75 febrile seizures.

Baseline: 152 febrile seizures followed pertussis vaccines in 1998.

Target setting method: 50 percent improvement.

Data sources: Vaccine Adverse Event Reporting System (VAERS); Vaccine Safety Datalink (VSD), CDC, NIP.

ORIGINAL OBJECTIVE

14-31.

Increase the number of persons under active surveillance for vaccine safety via large linked databases.

Target: 13 million persons.

Baseline: 6 million persons were under active surveillance for vaccine safety via large linked databases in 1999.

Target setting method: 117 percent improvement.

Data source: Vaccine Safety Datalink, CDC, NIP.

OBJECTIVE WITH REVISIONS

14-31.

Increase the ~~number of persons under active surveillance for vaccine safety via~~ ~~large linked databases~~ scientific knowledge on vaccines and adverse events.

Target and baseline:

Objective	Increase in the Scientific Knowledge on Vaccines and Adverse Events	1999 Baseline (unless noted) Number of Persons (in Millions)	2010 Target Number of Persons (in Millions)
14-31a.	Persons under active surveillance for vaccine safety via large linked databases	6	13
		Percent	Percent
14-31b.	Proportion of total Vaccine Adverse Event Reporting System (VAERS) reports submitted electronically	12 (2003)	30

Target setting method: For 14-31a, 117 percent improvement; for 14-31b, expert judgment and knowledge of programs currently in place.

Data sources: Vaccine Safety Datalink, CDC, NIP; Vaccine Adverse Events Reporting System (VAERS), CDC, NIP.

REVISED OBJECTIVE

14-31.

Increase the scientific knowledge on vaccines and adverse events.

Target and baseline:

Objective	Increase in the Scientific Knowledge on Vaccines and Adverse Events	1999 Baseline (unless noted) Number of Persons (in Millions)	2010 Target Number of Persons (in Millions)
14-31a.	Persons under active surveillance for vaccine safety via large linked databases	6	13
		Percent	Percent
14-31b.	Proportion of total Vaccine Adverse Event Reporting System (VAERS) reports submitted electronically	12 (2003)	30

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