Fewer children born in the first two years of the COVID-19 pandemic received recommended vaccines than children born in the two years before the pandemic, according to CDC data.
Compared to vaccination rates in 2018 and 2019, estimated vaccination rates for children born in 2020 and 2021 decreased by 1.3 to 7.8 percentage points, depending on the vaccine, according to the CDC National Center for Immunization and Respiratory Diseases. reported Holly Hill, MD. and colleagues wrote the Morbidity and Mortality Weekly Report.
The estimated difference in vaccination coverage up to 24 months of age for children born in 2018-2019 and children born in 2020-2021 is:
Influenza vaccine, 2 or more doses: -7.8 percentage points 7-dose combination vaccine series: -3.2 percentage points Rotavirus vaccine: -2.0 percentage points Diphtheria, tetanus, pertussis (DTaP) vaccine: 3 or more doses: -1.8 percentage points . -2.5 percentage points for 4 or more doses Haemophilus influenzae type b (Hib) conjugate vaccine: -2.2 percentage points for primary series; -3.2 percentage points for full series pneumococcal conjugate vaccines: -1.8 percentage points for three or more doses. -2.7 percentage points for 4 or more doses Hepatitis A vaccine, 1 or more doses: -1.6 percentage points Measles, mumps, rubella (MMR) vaccine: -1.7 percentage points Poliovirus vaccine: -1.5 percentage points Varicella vaccine : -1.3 percentage points Hepatitis B vaccine, 3 or more doses: -1.5 percentage points
“Analysis of early birth cohort (National Immunization Survey – Children) data does not reveal such widespread declines in routine childhood immunization coverage,” Hill and co-authors said. is writing.
On a positive note, despite the decline, vaccination coverage for poliovirus, MMR, DTaP, Hib, and hepatitis B among children born in 2020-21 remained above 90%.
However, only 56% of children nationwide received at least two doses of the influenza vaccine in 2020-2021, down from 63% in 2018-2019.
The CDC’s Advisory Committee on Immunization Practices (ACIP) currently recommends routine vaccination against 15 potentially serious diseases for children up to 24 months of age.
“Recent declines in coverage rates for most ACIP-recommended childhood vaccines are leading to a resurgence in vaccine-preventable diseases such as measles, varicella, and rotavirus and their associated morbidity and mortality. “This is a possibility,” Hill and his team said, citing the recent spike in cases. Measles in the United States As of September 26, there were 264 measles cases reported in the United States in 2024, 88% of which occurred in people who were unvaccinated or whose vaccination status was unknown.
Separately, the CDC recently announced that the number of pertussis (whooping cough) cases this year has exceeded levels seen before the pandemic.
Hill and his colleagues also found disparities in vaccination rates by race and ethnicity among people born between 2020 and 2021. Black, Hispanic or Latino, and American Indian or Alaska Native children receive 4 or more doses of DTaP vaccine, 4 or more doses of pneumococcal conjugate vaccine, rotavirus vaccine, and heptad vaccine. had lower vaccination rates than white children. series. Influenza vaccination rates with two or more doses were also lower among black (43%) and Hispanic (53%) children than among white children (60%). Children in Asia had the highest influenza vaccination rate at approximately 71%.
Hill and his co-authors noted that health insurance appears to be influencing vaccine uptake. In 2020-2021, children who were uninsured or covered by Medicaid or other non-private insurance had lower vaccination rates than children with private insurance. Furthermore, vaccination rates among children living below the poverty line ranged from 2.7 percentage points lower for the MMR vaccine to nearly 20 percentage points lower for two or more doses of influenza vaccine.
Looking at birth cohorts in various U.S. Health and Human Services jurisdictions, coverage of nearly all eight vaccine measures decreased from 2018-2019 to 2020-2021.
“Children born during or after major disruptions to primary care due to the COVID-19 pandemic may not have received some vaccinations, so health care providers should review children’s medical histories. , we need to recommend necessary vaccinations at every clinical encounter,” Hill and colleagues wrote.
“Addressing economic barriers and other access issues, along with concerns about vaccine hesitancy and misinformation, are critical to increasing vaccination rates and reducing disparities,” they added. .
Increasing health care provider participation in childhood vaccine programs could increase access to free vaccines and reduce financial barriers, the researchers said. Other strategies recommended to improve vaccine uptake include the use of standing orders or other prompts, reminder/recall systems, strong physician recommendations for vaccination, and vaccination in alternative settings.
This study is based on data from the National Immunization Survey-Children, a national survey of parents or guardians of children 19 to 35 months old in the United States. The researchers collected data through telephone interviews with households and reviewed vaccination records from the child’s health care provider. Among the sample households, the response rate was 27%, with adequate provider data available for 48% of the children who completed interviews. A total of 28,688 children were included in the analysis.
Katherine Kahn is a staff writer for MedPage Today, covering the infectious disease beat. She has been a medical writer for over 15 years.
disclosure
Mr. Hill and his coauthors report no conflicts of interest.
primary source
Morbidity and Mortality Weekly Report
References: Hill HA et al. Declining vaccination rates by 24 months and disparities in vaccination for children born in 2020 and 2021 — National Immunization Survey – Children in the United States, 2021-2023 ”MMWR 2024; DOI: 10.15585/mmwr.mm7338a3.
