Given the high rates of some vaccine-preventable disease in the prevaccine era among many AI/AN communities, ensuring high immunization coverage is especially important. American Indian/AN children receive immunizations in a variety of settings, including IHS, tribal, and urban Indian health facilities and from other public and private health care providers. The IHS collects quarterly immunization coverage data on approximately 25 000 AI/AN children aged 19 to 35 months who are served by IHS-funded facilities, representing approximately 25% of the US Census population defined as AI/AN alone or in combination with other races in this age group. These reports show coverage that is comparable to, or higher than, coverage reported by the National Immunization Survey (NIS) for the general US population, although variation between geographic areas exists. The NIS is a random-digit–dialed survey used to monitor immunization coverage in the United States and progress toward the achievement of the Healthy People 2010 goals. An analysis of NIS data from 2000 through 2005 found that AI/AN children overall had lower immunization coverage compared with the white population in some years; sample sizes were too small to allow for analysis by geographic region.74 In 2007, however, the NIS reported comparable coverage for AI/AN children (point estimate, 82.7%; 95% CI, ±7.5%) and white children (77.5%; ±1.3%) with the 4:3:1:3:3:1 vaccine series (>4 doses of diphtheria, tetanus toxoid, and any acellular pertussis vaccine, which can include diphtheria and tetanus toxoid vaccine or diphtheria, tetanus toxoid, and pertussis vaccine; >3 doses of poliovirus vaccine; >1 dose of measles, mumps, and rubella vaccine; >3 doses of Hib vaccine; >3 doses of hepatitis B vaccine; and >1 dose of varicella vaccine).75 The IHS data reported similarly high rates (77.1% in 2008).76 In the NIS and IHS data, coverage in the AI/AN population with most of the individual vaccines in the 4:3:1:3:3:1 series is near or above 90% (coverage with the fourth dose of the diphtheria, tetanus toxoid, and pertussis vaccine is the exception). In addition, coverage with 4 doses of PCV 7 is significantly higher in the AI/AN population (80.4%) compared with the white population (75.3%).75 These high individual vaccine coverage rates suggest that residual disease occurring among previously high-risk AI/AN children is not a result of underimmunization. Ongoing monitoring of vaccine coverage levels, however, is needed to ensure that coverage disparities do not reemerge.