Change Request Justification

Nonsubstantive Change Request

NATIONAL HEALTH INTERVIEW SURVEY

OMB No. 0920-0214, Expiration Date 12/31/2023

Contact Information:

Stephen Blumberg

Division of Health Interview Statistics

National Center for Health Statistics/CDC

3311 Toledo Road

Hyattsville, MD 20782

301.458.4107 (voice)

301.458.4035 (fax)

[email protected]

February 1, 2021

Table of Contents

1. Circumstance Making the Collection of Information Necessary 3

2. Purpose and Use of Information Collection 4

12. Estimates of Annualized Burden Hours and Costs 4

15. Explanation for Program Changes or Adjustments 6

List of Attachments

Attachment 1 - 2021 Sample Adult COVID-19 Vaccination Questions

Attachment 2 - 2021 Sample Child COVID-19 Vaccination Questions

NCHS National Health Interview Survey

This is a request for approval of a nonsubstantive change to the National Health Interview Survey (NHIS) (OMB No. 0920-0214, Exp. Date 12/31/2023), conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC).

The NHIS is planning to add items on COVID-19 vaccination to the Sample Adult questionnaire (Attachment 1) beginning on April 1, 2021. Additionally, the NHIS is planning to add similar items to the Sample Child questionnaire beginning July 1 or October 1, 2021 (Attachment 2). This content was incorporated into the burden estimates in the initial submission, but at that time, the items themselves were not yet finalized.

This is a nonsubstantive change request to approve the final item text.

The following are proposed for both the Sample Adult and Sample Child questionnaires.

• Have you [Sample Child] had a COVID-19 vaccination?

• How many COVID-19 vaccinations have you [Sample Child] received?

• During what month and year did you [Sample Child] receive your [his/her] most recent COVID-19 vaccination?

• During what month and year did you [Sample Child] receive your [his/her] next most recent COVID-19 vaccination?

• Did a doctor or other health professional tell you [Sample Child] that you [he/she] need an additional dose of the COVID-19 vaccination?

1. Justification

1. Circumstance Making the Collection of Information Necessary

The NHIS is conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) to collect, on an annual basis, statistically valid data on the amount, distribution, and effects of illness and disability in the population and on the utilization of health care services for such conditions. The NHIS has been conducted every year since 1957, and the questionnaire has been periodically redesigned to reflect the latest state of the science and maintain the survey’s topical relevance toward its critical public health mission.

The 2021 NHIS is currently in the field. The United States is currently experiencing the COVID-19 pandemic. When the data collection for the 2021 NHIS began in January, vaccination protocols for COVID-19 had not yet been fully developed. Anticipating their development , the National Center for Immunization and Respiratory Diseases proposed a set of items to capture COVID-19 vaccination coverage of the U.S. population, but could not finalize the text until actual protocols had been developed and implemented.

Now that the Moderna and Pfizer vaccination protocols are being implemented for the adult population, National Center for Immunization and Respiratory Diseases has finalized the items and is proposing that data collection begins April 1.

They also propose adding these items to the Sample Child questionnaire later in the year after clinical trials provide evidence for the safety and effectiveness of the vaccine for children. The items have been modeled after the influenza vaccination questions to facilitate a waiver application under the National Childhood Vaccine Injury Act (NCVIA) [Public Law 99-660, section 321-Title III] for addition to the NHIS.

2. Purpose and Use of Information Collection

The purposes of the NHIS are (1) to provide national data on an annual basis on the prevalence of chronic conditions and impairments, the extent of disability, the utilization of health care services, and other health-related topics; (2) to provide more detailed information on selected topics periodically and on a one time basis; and (3) to provide a sampling frame for the Medical Expenditure Panel Survey and other follow-back surveys. It is also a main provider of data for the Congressionally mandated Health, United States report and provides data for many indicators used in monitoring progress toward current Healthy People goals and for detailing health disparities.

Like with other data on vaccinations collected on the NHIS, the data will be used to produce national adult, child and population estimates of COVID-19 vaccination coverage. A major strength of the NHIS is its ability to display health characteristics by selected demographic and socio-economic characteristics of the U.S. civilian, noninstitutionalized population. NHIS data are typically used for program planning and evaluation, public health education and health promotion and epidemiological research. Since COVID-19 vaccination coverage can be expected to be high, subpopulation comparisons can also be made.

12. Estimates of Annualized Burden Hours and Costs

1. Time Estimates

Estimated Annualized Burden Hours

The anticipated COVID-19 vaccination items were incorporated into the time estimates of the initial submission, and are repeated here.

The estimated overall average annual burden for the 2021 NHIS, including the roster, adult questionnaire, child questionnaire, methodological projects, adolescent follow-back survey, health exam and the reinterview component, is 42,845 hours. The average annual burden for 2022 and 2023 is estimated to be comparable to this estimated burden for 2021.

Lines 1-3 of the burden table represent the different sections of the NHIS questionnaire. Line 4 covers the methodological projects such as web and/or mail-based methodological, cognitive testing activities, and pilot studies. Line 5 covers the adolescent follow-back survey. Line 6 covers a follow-up health exam. Small quality control resurveys of participating households are represented on line 7.

Estimated Annualized Burden Hours

Type of Respondent	Form Name	Number of Respondents	Number of Responses per respondent	Average Burden per Response (in hours)	Total Burden Hours
Adult Household Member	Household Roster	36,000	1	4/60	2,400
Sample Adult	Adult Questionnaire	30,000	1	48/60	24,000
Adult Family Member	Child Questionnaire	10,000	1	19/60	3,167
Adult Family Member	Methodological Projects	15,000	1	20/60	5,000
Sample Child	Adolescent follow-back survey	1,200	1	16/60	320
Sample Adult	Health Exam	10,000	1	45/60	7,500
Adult Family Member	Reinterview Survey	5,500	1	5/60	458
Total					42,845

B. Cost to Respondents

The anticipated COVID-19 vaccination items were incorporated into the cost to respondents estimates of the initial submission, and are repeated here.

At an average wage rate of $21.00 per hour, the estimated annualized cost for the 42,845 burden hours is

$899,745. This estimated cost does not represent an out of pocket expense but represents a monetary value attributed to the time spent doing the interview.

Estimated Annualized Burden Costs

Type of Respondent	Form Name	Total Burden Hours	Hourly Wage Rate	Total Respondent Costs
Adult Household Member	Household Roster	2,400	$21.00	$50,400
Sample Adult	Adult Questionnaire	24,000	$21.00	$504,000
Adult Family Member	Child Questionnaire	3,167	$21.00	$66,500
Adult Family Member	Methodological Projects	5,000	$21.00	$105,000
Sample Child	Adolescent follow-back survey	320 267	$21.00	$6,720
Sample Adult	Health Exam	7,500	$21.00	$157,500
Adult Family Member	Reinterview Survey	458	$21.00	$9,625
Total	$899,745

15. Explanation for Program Changes or Adjustments

When the initial submission was reviewed by OMB, COVID-19 vaccination protocols had not been finalized, and while it was possible to draft potential survey items, it was not possible to finalize them. Now that the Moderna and Pfizer COVID-19 vaccines protocols are being implemented, National Center for Immunization and Respiratory Diseases has finalized a set of items and is proposing data collection to begin April 1.

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