COVID-19 and Completion of Select Routine Childhood Vaccinations

Area of Science:

• Pediatric infectious disease epidemiology
• Public health surveillance
• Vaccine-preventable diseases

Background:

• Routine childhood immunizations are critical for preventing infectious diseases.
• Assessing vaccine coverage trends is essential for public health planning.
• The COVID-19 pandemic has impacted healthcare access and routine services.

Purpose of the Study:

• To evaluate vaccine coverage for rotavirus (RV), diphtheria, tetanus, and acellular pertussis (DTaP), and pneumococcal conjugate vaccine (PCV).
• To identify factors associated with vaccine uptake in infants from 2018 to 2023.
• To assess the impact of the COVID-19 pandemic on childhood immunization rates.

Main Methods:

• Retrospective cohort study of infants born between January 1, 2018, and May 31, 2023.
• Inclusion criteria: minimum 9 months enrollment, at least one medical visit between 9-12 months.
• Evaluation of 2-dose RV, DTaP, and PCV coverage at 5 months and series completion by 12 months; analysis of demographic factors and time period associations.

Main Results:

• Included 395,143 infants; 48.4% female, 14.7% non-Hispanic Asian, 5.8% non-Hispanic Black, 34.2% Hispanic, 20.6% on Medicaid.
• Two-dose vaccine coverage at 5 months decreased from 87.8% (Feb 2020) to 80.8% (Oct 2023).
• Lower uptake associated with non-English/Spanish primary caregiver language, non-Hispanic Black race, and Medicaid enrollment.

Conclusions:

• Childhood immunization coverage remains below prepandemic levels over three years post-COVID-19 onset.
• Demographic factors likely reflect structural barriers impacting vaccine access.
• Targeted interventions are crucial to enhance vaccine coverage across all populations.