North Dakota Vaccination Coverage

Monitoring vaccination coverage rates is important to the people of North Dakota, to public and private health-care providers and to government agencies. Maintaining high vaccination coverage helps protect all North Dakotans from vaccine preventable disease. With timely, detailed immunization data the ability of all stakeholders to coordinate effective vaccination strategies and help maintain high vaccine coverage rates is greatly increased. There are a variety of methods and surveys to measure vaccine coverage in North Dakota.


North Dakota Immunization Information System (NDIIS):

A widely used accepted source for immunization data is immunization information systems (IIS). IISs are confidential population based, computerized information systems that attempt to collect vaccination data for all persons within a state or geographical area. Ideally IISs, such as the NDIIS, provide supplemental data that surveys like the NIS are not designed to obtain by providing local level data and a timely surveillance system. IISs also have limitations. First, an IIS is only as good as the data within the IIS. In North Dakota health-care providers are required to enter child and adolescent data into the NDIIS, but adult vaccines are not required to be entered. As a result the NDIIS is less able to estimate adult vaccination coverage. Second, to determine a population denominator, the number of people in a geographic area, using the NDIIS can be difficult due to people moving in and out of different areas; as a result the NDIIS tends to underestimate vaccination coverage compared to the NIS.


Childhood Immunization Rates (calculated from NDIIS data)

Individual Vaccines and Vaccine Series
Birth Dose of Hepatitis B Vaccine
Timeliness of Vaccine Entry

Adolescent Immunization Rates (calculated from NDIIS data)

Individual Vaccines and Vaccine Series
HPV Vaccine Uptake

Adult Immunization Rates (calculated from NDIIS data)

NDIIS Participation
Individual Vaccines

Influenza Immunization Rates (calculated from NDIIS data)

2016-2017 Influenza Season

Immunization Exemption Rates (calculated from NDIIS data)

NDIIS Infant, Pediatric and Adolescent Exemptions

National Immunization Survey (NIS):

For children and adolescents, the NIS is the gold standard for determining vaccination coverage in the United States. The NIS provides highly accurate data on immunization rates and overall trends in vaccination coverage in the US. However, there are a few limitations of NIS data. First, it takes a year to collect the target sample size per area and, as a result, NIS data are reported for the previous year leaving a gap between changes in the vaccine schedule and evaluation by the NIS.  Second, the NIS is not designed to provide precise estimates for smaller geographic areas or for population subgroups within states.

North Dakota Behavioral Risk Factor Surveillance System (BRFSS):

The BRFSS is the world’s largest ongoing telephone health survey system, tracking health conditions and risk behavior in the US yearly since 1984. For determining influenza vaccine coverage the BRFSS is one of the best methods. It has limitations in that it requires survey respondents to self-report vaccination coverage unlike the NIS that verifies immunization data with provider records.