Appendix for Surveillance of Vaccination Coverage Among Adult Populations —United States, 2018

Appendix: Ascertainment of Vaccination Status

Influenza vaccination: Respondents were asked if they had received an influenza shot or nasal spray during the preceding 12 months and, if so, in which month and year.

Pneumococcal vaccination: Respondents were asked if they had ever had a pneumonia shot, and if yes, how many doses were received. There were no questions in the 2018 National Health Interview Survey (NHIS) to ascertain pneumococcal vaccination by type of vaccine (23-valent pneumococcal polysaccharide vaccine or 13-valent pneumococcal conjugate vaccine).

Tetanus vaccination: Before the 2017 NHIS, respondents were asked if they had received a tetanus shot during the preceding 10 years. Respondents who had received a tetanus shot during the preceding 10 years were asked if their most recent shot was received in 2005 or later. Respondents who had received a tetanus shot since 2005 were asked if they were told that their most recent tetanus shot included the pertussis or whooping cough vaccine. Starting from the 2017 NHIS, respondents were asked if they had received a tetanus shot in the past 10 years. Respondents who had received a tetanus shot in the past 10 years were asked if they were told that their most recent tetanus shot included the pertussis or whooping cough vaccine.

Hepatitis A vaccination: Respondents were asked if they had ever received the hepatitis A vaccine and, if yes, how many doses were received.

Hepatitis B vaccination: Respondents were asked if they had ever received the hepatitis B vaccine and, if yes, whether they had received ≥3 doses or <3 doses.

Herpes zoster vaccination: Before the 2018 NHIS, respondents were asked if they had ever received a shingles vaccine. Starting with the 2018 NHIS, respondents were asked if they had ever received a shingles vaccine and, if yes, what type of vaccine received (zoster vaccine live or recombinant zoster vaccine), number of vaccine doses received, and timing of vaccine receipt.

Human papillomavirus vaccination (HPV): Respondents were asked if they had ever received an HPV shot or cervical cancer vaccine and, if yes, how many doses were received and age at the first dose.

Classification as Health Care Personnel

Adults were classified as health care personnel if they reported that they volunteer or work in a hospital, medical clinic, doctor’s office, dentist’s office, nursing home, or some other health care facility, including part-time and unpaid work in a health care facility, including emergency responders and public safety personnel, as well as professional nursing care provided in the home. If yes, respondents were asked whether they provide direct patient care (physical or hands-on contact with patients) as part of their work.

Ascertainment of Travel Status

Respondents were asked whether they had ever traveled outside the United States to countries other than Europe, Japan, Australia, New Zealand, or Canada since 1995.

Ascertainment of Health Insurance Status

Adults were considered insured if they reported having public health insurance coverage (Medicare, Medicaid, military health care [TRICARE/VA/CHAMP-VA], Indian Health Service, state-sponsored health plan, or other government program insurance) or private health insurance coverage.

Ascertainment of Having a Usual Place for Health Care

Respondents were asked if there is a place to which they usually go when sick or need advice on their health. Respondents answering “yes” were defined as having a usual place for health care.

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