Vaccine Administration in Children's Hospitals

Area of Science:

• Pediatric Health
• Immunization Practices
• Hospital-Based Interventions

Background:

• Childhood vaccination is crucial for public health.
• Inpatient settings offer opportunities for vaccine delivery.
• Current inpatient vaccine administration rates and variability are not well-characterized.

Purpose of the Study:

• To examine inpatient vaccine delivery across a national sample of children's hospitals.
• To determine the proportion of hospitalizations involving vaccine administration.
• To identify factors associated with vaccine administration in hospitalized children.

Main Methods:

• Retrospective cohort study using the Pediatric Health Information System database.
• Included children <18 years old admitted to 49 children's hospitals between July 2017 and June 2019.
• Analyzed vaccine administration rates, types, and associated demographic and clinical characteristics using logistic and linear regression.

Main Results:

• Over 1.5 million hospitalizations were analyzed.
• Vaccine doses were administered in 12.9% of hospitalizations, with significant hospital-level variability (1%-45%).
• Hepatitis B and influenza vaccines were most common; other vaccines were administered in 1.9% of cases. Younger age, public insurance, Black race, medical complexity, and longer stays were associated with receiving vaccines.

Conclusions:

• Inpatient vaccine administration is infrequent and highly variable in US children's hospitals.
• Standardizing inpatient vaccine delivery may enhance childhood vaccine coverage.
• Targeted interventions are needed to optimize vaccine delivery in hospitalized children.