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Vital Signs: Trends and Disparities in Childhood Vaccination Coverage by Vaccines for Children Program Eligibility -
Insights
The Vaccines for Children (VFC) program ensures vaccine access for eligible children. However, VFC-eligible children have lower vaccination coverage rates than non-VFC-eligible children, highlighting persistent gaps in protection.
Area of Science:
- Public Health
- Immunization
- Pediatrics
Background:
- The Vaccines for Children (VFC) program, established in 1994, aims to provide recommended vaccines at no cost to eligible children in the U.S.
- The program seeks to ensure comprehensive protection against vaccine-preventable diseases for all children.
Purpose of the Study:
- To analyze vaccination coverage trends among VFC-eligible and non-VFC-eligible children.
- To examine sociodemographic differences in coverage among VFC-eligible children.
- To assess coverage for measles, mumps, and rubella (MMR) vaccine, rotavirus vaccine, and a combined 7-vaccine series.
Main Methods:
- Analysis of data from the 2012-2022 National Immunization Survey-Child (NIS-Child).
- VFC eligibility defined by American Indian/Alaska Native status, insurance status (Medicaid, IHS, uninsured), or vaccination at IHS/Tribal facilities.
- Assessment of vaccination coverage by age 24 months for MMR and the 7-vaccine series, and by age 8 months for rotavirus vaccine.
Main Results:
- Approximately 52.2% of U.S. children were VFC eligible.
- Coverage for ≥1 MMR dose and the 7-vaccine series remained stable among VFC-eligible children (2011-2020 births).
- Rotavirus vaccination coverage increased annually by 0.7 percentage points.
- In 2020, VFC-eligible children had lower coverage rates: 3.8% for MMR, 11.5% for rotavirus, and 13.8% for the 7-vaccine series compared to non-VFC-eligible children.
Conclusions:
- Despite the VFC program's success over 30 years, disparities in childhood vaccination coverage persist.
- Enhanced strategies are needed to improve awareness, confidence, and access to recommended vaccines for VFC-eligible children.
- Addressing these gaps is crucial for maintaining high immunization rates and preventing vaccine-preventable diseases.
Introduction:
The Vaccines for Children (VFC) program was established in 1994 to provide recommended vaccines at no cost to eligible children and help ensure that all U.S. children are protected from life-threatening vaccine-preventable diseases.
Methods:
CDC analyzed data from the 2012-2022 National Immunization Survey-Child (NIS-Child) to assess trends in vaccination coverage with ≥1 dose of measles, mumps, and rubella vaccine (MMR), 2-3 doses of rotavirus vaccine, and a combined 7-vaccine series, by VFC program eligibility status, and to examine differences in coverage among VFC-eligible children by sociodemographic characteristics. VFC eligibility was defined as meeting at least one of the following criteria: 1) American Indian or Alaska Native; 2) insured by Medicaid, Indian Health Service (IHS), or uninsured; or 3) ever received at least one vaccination at an IHS-operated center, Tribal health center, or urban Indian health care facility.
Results:
Overall, approximately 52.2% of U.S. children were VFC eligible. Among VFC-eligible children born during 2011-2020, coverage by age 24 months was stable for ≥1 MMR dose (88.0%-89.9%) and the combined 7-vaccine series (61.4%-65.3%). Rotavirus vaccination coverage by age 8 months was 64.8%-71.1%, increasing by an average of 0.7 percentage points annually. Among all children born in 2020, coverage was 3.8 (≥1 MMR dose), 11.5 (2-3 doses of rotavirus vaccine), and 13.8 (combined 7-vaccine series) percentage points lower among VFC-eligible than among non-VFC-eligible children.
Conclusions And Implications For Public Health Practice:
Although the VFC program has played a vital role in increasing and maintaining high levels of childhood vaccination coverage for 30 years, gaps remain. Enhanced efforts must ensure that parents and guardians of VFC-eligible children are aware of, have confidence in, and are able to obtain all recommended vaccines for their children.
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