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Pediatric influenza vaccination rates lower than previous estimates in the United States
Dana M Gates1, Steven A Cohen2, Kelly Orr1
1College of Pharmacy, University of Rhode Island, Kingston, RI, United States.
Insights
Pediatric influenza vaccination coverage is lower in commercially insured children than previously estimated. More accurate surveillance and interventions are needed to reach national vaccination goals.
Area of Science:
- Pediatric Health
- Immunization Science
- Public Health Surveillance
Background:
- National Immunization Survey (NIS-Flu) data are used to estimate pediatric influenza vaccination coverage.
- From 2010-2017, NIS-Flu estimated coverage between 51-59%, but limitations exist.
- This study addresses limitations by analyzing a large, commercially insured pediatric cohort.
Purpose of the Study:
- To describe temporal trends in pediatric influenza vaccination coverage.
- To identify demographic differences in vaccination coverage.
- To compare coverage estimates between a commercial insurance database and national survey data.
Main Methods:
- Utilized de-identified Optum Clinformatics® Data Mart database for children (<18 years) with continuous enrollment (07/01/2010-06/30/2017).
- Assessed influenza vaccination coverage and compared with NIS-Flu data.
- Employed Joinpoint regression to analyze time trends, stratified by age, sex, and region.
Main Results:
- Average annual pediatric influenza vaccination coverage was 33.4% in the study cohort versus 56.5% in NIS-Flu (p<0.0001).
- Coverage was highest in 6 months-4 years (52.6%) and lowest in 13-17 years (20.1%).
- Coverage remained stable in the study cohort (1.8% annual change) but increased significantly in NIS-Flu (2.8% annual increase).
Conclusions:
- Commercially insured pediatric vaccination coverage was 51.4% lower than NIS-Flu estimates.
- Highlights the need for improved vaccination coverage surveillance methods.
- Effective interventions are crucial to achieve the Healthy People 2020 target of 70% pediatric vaccination coverage.
Background:
Annually, pediatric influenza vaccination coverage estimates are ascertained from health surveys, such as the National Immunization Survey (NIS-Flu). From 2010 to 2017, vaccination coverage among children ranged from 51 to 59 %. Recognizing the limitations of national health survey data, we sought to describe temporal trends in pediatric influenza vaccination coverage, and demographic differences among a commercially insured large national cohort from 07/01/2010 to 06/30/2017.
Methods:
Influenza vaccination coverage was assessed among children (<18 years) with continuous enrollment in the de-identified Optum Clinformatics® Data Mart database, and from NIS-Flu. Time trends in vaccination coverage were assessed using Joinpoint regression, overall and stratified by age group, sex, and geographic region.
Results:
The average annual pediatric influenza vaccination coverage was 33.4 % in our study population versus 56.5 % reported from NIS-Flu during the same period (p-value < 0.0001). Vaccination coverage was highest in children 6 months-4-years old at 52.6 % (versus 68.8 % NIS-Flu, p-value < 0.0001), and lowest in the 13-17-year-old age group at 20.1 % (versus 42.8 % NIS-Flu, p-value < 0.0001). Vaccination coverage over time remained stable in our study population (average annual percent change 1.8 %, 95 % confidence interval [CI] -2.3 % to 6.0 %) versus significantly increasing by 2.8 % in NIS-Flu (95 % CI 0.3 % to 5.3 %).
Conclusions:
Vaccination coverage in our commercially insured pediatric population was 51.4% lower than estimates from NIS-Flu during the same period, suggesting the need for more accurate vaccination coverage surveillance, which will also be critical in future COVID-19 vaccination efforts. Effective interventions are needed to increase pediatric influenza vaccination rates to the Healthy People 2020 target of 70%.
