Hawaiʻi Health Data Warehouse

Immunizations and Screenings

Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease.1 Screenings are medical tests that doctors use to check for certain disorders before there are any symptoms. Regular health screenings help identify problems early, when chances for treatment and cure are better.2 The United States (US) Centers for Disease Control and Prevention (CDC) recommends routine vaccination to prevent vaccine-preventable diseases that occur in infants, children, adolescents, and adults.3

Why It’s Important

Preventive services detect illnesses and diseases in their more treatable stages, significantly reducing the risk of illness, disability, early death, and medical care costs.2 Immunization is a proven tool for controlling and eliminating life-threatening infectious diseases and is estimated to avert between 3.5 and 5 million deaths each year. It is one of the most cost-effective health investments, with proven strategies that make it accessible to even the most hard-to-reach and vulnerable populations.4 Community immunity is also important for the very small group of people who don’t have a strong immune response from vaccines.1

What Is Known

Among Hawaiʻi children aged 35 months in 2018, 77.6% received the recommended combined 7 vaccine series (NIS Child Vax). Among teens age 13-17 in 2020, 73.9% are up-to-date with the HPV vaccine series (NIS Teen Vax).

In Hawaiʻi in 2020 (BRFSS):

  • 41% of adults aged 18-64 years received an influenza vaccination in the past year.
  • 63% of adults aged 65 years and older received an influenza vaccination in the past year.
  • 80% of women aged 21-65 years had a cervical cancer screening.
  • 35% of young adults aged 18-44 years had ever been tested for human immunodeficiency virus.

Who Is at Risk


Everyone can be at risk for vaccine-preventable disease depending on their age, job, lifestyle, travel, or health condition. Even vaccinated people are at risk for disease if there is not adequate immunization coverage in the population. Children with non-medical exemptions and exemptions from school immunization requirements are at increased risk for acquiring and transmitting vaccine-preventable diseases. They can infect others who are too young to be vaccinated, cannot be vaccinated for medical reasons, or are vaccinated but do not have a sufficient immunologic response. Certain racial and ethnic minority groups, individuals with disabilities, rural communities, older adults, and individuals living with chronic conditions face vaccine inequities that puts them at risk of vaccine-preventable diseases.3


Regular medical visits with a primary care provider can help ensure a person receives age-appropriate screening and tests. However, barriers to screening include lack of health insurance, and lack of access to a primary care provider which can be due a variety of factors including inadequate supply, cost, location, or lack of transportation or time off work or school to attend appointments.5

How To Reduce Risk

The CDC recommends routine immunization to prevent 16 vaccine-preventable diseases that occur in infants, children, adolescents and adults.3 Health care providers play a crucial role in parental decision-making with regards to immunization. Policy interventions, such as immunization requirements for school entry, have contributed to high vaccine coverage and record lows in the levels of vaccine-preventable diseases. Herd immunity assists in reducing transmission of a number of vaccine-preventable diseases.6

Page last updated July 29, 2022

Indicator Reports


A health indicator is a measure designed to summarize information about a given topic in population health or health systems performance.  Indicator reports provide numeric data for a health indicator as well as public health context (such as why it is important and what is being done to improve it).

Customizable Reports


Many of the topic areas come from datasets that you can use to create your own tables, charts, and maps.  These data query results pages will also have dataset details, including data sources and tips on how data can or cannot be used.

How It’s Tracked

For more information on tracking Immunizations and Screening objectives, please visit the Healthy People 2030 Vaccination objectives and the Preventive Care pages.


1 Vaccine glossary of terms. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/terms/glossary.html#v. Published July 30, 2020. Accessed July 20. 2022.
2 Routine screenings. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/routine-screenings Accessed July 20. 2022.
3Vaccines and immunizations. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/index.html Published February 16, 2021. Accessed July 20. 2022.
4 Vaccines and immunization. World Health Organization. https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1. Accessed July 20. 2022.
5Preventive care. Preventive Care – Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/browse-objectives/preventive-care. Accessed July 20. 2022.
6Bjork A, Morelli V. 3. Immunization Strategies for Healthcare Practices and Providers. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. 14th ed. Washington, D.C. : Public Health Foundation; 2021:29-42.