Gaps in Routine Childhood Immunization Among Low-Income Children at 24 Months (2019-2024)

Area of Science:

• Public Health
• Pediatrics
• Epidemiology

Background:

• Routine childhood vaccination rates declined during the COVID-19 pandemic.
• These declines have not fully recovered post-pandemic, posing risks for childhood disease resurgence.
• This study examines vaccination trends in underserved populations.

Purpose of the Study:

• To assess trends in required childhood vaccination rates at 24 months from 2019 to 2024.
• To analyze vaccination rates by patient demographics and utilization patterns.
• To identify factors influencing vaccination coverage.

Main Methods:

• Utilized electronic health record data from 213 primary care centers serving underserved populations across 10 states.
• Calculated routine vaccination metrics over a 6-year period (2019-2024).
• Analyzed up-to-date vaccination rates, considering well-child visits and influenza vaccine inclusion.

Main Results:

• Vaccination rates at 24 months increased from 2019 to 2020, then declined from 2021 to 2024.
• The percentage of children up-to-date with all vaccines fell from 42% in 2020 to 30% in 2024.
• Higher rates were observed when excluding the influenza vaccine and among children with well-child visits.

Conclusions:

• Routine childhood vaccination coverage at 24 months has declined since the COVID-19 public health emergency.
• Continued decline necessitates targeted strategies to boost childhood immunization.
• Addressing vaccination gaps is critical for preventing outbreaks of vaccine-preventable diseases.