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Impact of the COVID-19 Pandemic on National Pediatric Inpatient Vaccine Delivery

Alexandra J Mihalek1,2, Amanda M Schafenacker1,2, Katherine Andreeff1,2

  • 1Hospitalist Division, Children's Hospital of Orange County, Orange, California.

Hospital Pediatrics
|May 13, 2026
PubMed

Insights

Pediatric inpatient vaccine delivery rates generally increased, but saw significant declines for influenza vaccines (IIVs) and birth-dose hepatitis B (Hep B) after the COVID-19 pandemic began. Further research is needed to address these trends in hospital-based immunization.

Area of Science:

  • Pediatric Health
  • Immunization and Vaccination
  • Epidemiology

Background:

  • Pediatric vaccine uptake decreased during the COVID-19 pandemic.
  • The pandemic's specific impact on hospital-based pediatric immunizations remains largely unknown.
  • This study focuses on national inpatient vaccine delivery rates for key childhood vaccines.

Purpose of the Study:

  • To assess the pandemic's effect on inpatient pediatric vaccine delivery rates.
  • To analyze trends for hepatitis B (Hep B), Haemophilus influenzae type B (Hib), pneumococcal (PCV), tetanus (TTCV), and influenza (IIV) vaccines.
  • To compare pre-pandemic and post-pandemic vaccine delivery slopes.

Main Methods:

  • Retrospective analysis of the Cerner Real-World Data electronic health record database.
  • Inclusion of over 5.4 million pediatric inpatient encounters across 91 health systems.
  • Comparison of vaccine delivery rates during pre-pandemic (May 2017-April 2020) and post-pandemic (May 2020-April 2023) periods using interrupted time series analysis.

Main Results:

  • Overall vaccination rates increased across all vaccine types during the study period.
  • Significant decreases in the slope of monthly vaccine delivery rates were observed post-pandemic for influenza vaccines (IIVs) and birth-dose hepatitis B (Hep B).
  • No significant changes in delivery rate slopes were found for non-birth-dose Hep B, Hib, PCV, or TTCV.

Conclusions:

  • While inpatient vaccine delivery generally trended upward, the post-pandemic period saw reduced delivery rates for IIVs and birth-dose Hep B.
  • These findings highlight a need for further investigation into the factors influencing hospital-based vaccine delivery.
  • Optimizing strategies for hospital-based immunization programs is crucial to address observed declines.
Abstract

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