The CDC reported in Thursday's Mortality and Morbidity Weekly Report that more than 80 percent of toddlers got five of the six recommended vaccinations.
"Thanks in large part to these high immunization rates, we have seen a breathtaking decline in suffering and death from most vaccine-preventable diseases," Health and Human Services Secretary Donna Shalala said.
The rates for most vaccinations changed only slightly from the year before, though the chicken pox vaccine, first available in 1995, jumped from 43.2 percent of toddlers in 1998 to 59.4 percent.
The 50-state survey included interviews with the parents of 34,442 children 19- to 35-months-old. Vermont had the highest vaccination rate at 90.5 percent in 1999, and Oregon had the lowest at 72.3 percent.
"The good news is that we have sustained high immunization coverage in our preschool populations," said Dr. Walt Orenstein, director of the CDC's immunization program. "The concern is that each day 11,000 babies are born and they start at zero."
Indeed, CDC Director Dr. Jeffrey Koplan said he was pleased with the progress, but added, "the data also show there are still many children who are not adequately immunized."
In a study of vaccination inancing in the U.S. commissioned by the National Immunization Program and published last month, the Institute of Medicine found that "Vaccination rates in the United States are at a record high, but the system is starting to show signs of strain. Federal funds dedicated to supporting the immunization network are shrinking. State and local public health agencies are not adequately prepared to deliver new vaccines."
The Institute called for a $1.5 billion investment in immunizations over the next five years. The CDC said it would review the report.
The Clinton administration has made childhood vaccinations one of its top health policy goals, launching the Childhood Immunization Initiative in 1993 to vaccinate 90 percent of the nation's children by age 2 with the necessary doses of the six vaccines available for ten common childhood diseases.
That goal was attained by 1996 for every disease but Hepatitis-B.
According to the CDC, 12 to 16 vaccine doses are due by age two, requiring about six doctor visits. While 95 percent of children are vaccinated by kindergarten, "about one million pre-school children are not adequately protected against possibly fatal illnesses."
A vaccine is also available for Hepatitis-A, but the CDC only recommends it in areas where Hepatitis-A rates are very highmainly in the western states.
Of the nation's largest metropolitan areas, Houston had the lowest rate at 66.5 percent and Dade County, Fla., had the highest at 86.7 percent.