Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 31;40(5):706-713.
doi: 10.1016/j.vaccine.2021.12.064. Epub 2022 Jan 1.

Impact of the COVID-19 pandemic on pediatric and adolescent vaccinations and well child visits in the United States: A database analysis

Stephanie A Kujawski  1 , Lixia Yao  2 , H Echo Wang  3 , Cristina Carias  4 , Ya-Ting Chen  5
Affiliations

Impact of the COVID-19 pandemic on pediatric and adolescent vaccinations and well child visits in the United States: A database analysis

Stephanie A Kujawski et al. Vaccine. .

Abstract

Background: The COVID-19 pandemic has disrupted healthcare, including immunization practice and well child visit attendance. Maintaining vaccination coverage is important to prevent disease outbreaks and morbidity. We assessed the impact of the COVID-19 pandemic on pediatric and adolescent vaccination administration and well child visit attendance in the United States.

Methods: This cross-sectional study used IBM MarketScan Commercial Database (IMC) with Early View (healthcare claims database) and TriNetX Dataworks Global Network (electronic medical records database) from January 2018-March 2021. Individuals ≤ 18 years of age who were enrolled during the analysis month of interest (IMC with Early View) or had ≥ 1 health encounter at a participating institution (TriNetX Dataworks) were included. We calculated the monthly percent difference between well child visit attendance and vaccine administration rates for 10 recommended pediatric/adolescent vaccines in 2020 and 2021 compared with 2018-2019. Data were stratified by the age groups 0-2 years, 4-6 years, and 9-16 years.

Results: In IMC with Early View, the average monthly enrollment for children 0-18 years of age was 5.2 million. In TriNetX Dataworks, 12.2 million eligible individuals were included. Well child visits and vaccinations reached the lowest point in April 2020 compared with 2018-2019. Well child visit attendance and vaccine administration rates were inversely related to age, with initial reductions highest for adolescents and lowest for ages 0-2 years. Rates rebounded in June and September 2020 and stabilized to pre-pandemic levels in Fall 2020. Rates dropped below baseline in early 2021 for groups 0-2 years and 4-6 years.

Conclusions: We found substantial disruptions in well child visit attendance and vaccination administration for children and adolescents during the COVID-19 pandemic in 2020 and early 2021. Continued efforts are needed to monitor recovery and catch up to avoid outbreaks and morbidity associated with vaccine-preventable diseases.

Keywords: Adolescents; COVID-19; Infectious disease; Pediatrics; Vaccination coverage; Well-child visits.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest All authors are employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA and may own stock and/or hold stock options in the Company.

Figures

Fig. 1
Fig. 1
Percent difference of well child visits, 2020 and 2021 vs. 2018–2019, IBM MarketScan Commercial Database with Early View.
Fig. 2
Fig. 2
Percent difference of vaccination administration, 2020 and 2021 vs. 2018–2019, by age group, IBM MarketScan Commercial Database with Early View: (A) 0–2 years, (B) 4–6 years, (C) 9–16 years.
Fig. 3
Fig. 3
Percent difference of vaccination administration, 2020 and 2021 vs. 2018–2019 and 2021 vs. 2018–2019, for select vaccines, IBM MarketScan Commercial Database (IMC) with Early View and TriNetX Dataworks: (A) 0–2 years, (B) 4–6 years, (C) 9–16 years.
See this image and copyright information in PMC

References

    1. Bramer C.A., Kimmins L.M., Swanson R., Kuo J., Vranesich P., Jacques-Carroll L.A., et al. Decline in Child Vaccination Coverage During the COVID-19 Pandemic — Michigan Care Improvement Registry, May 2016–May 2020. MMWR Morb Mortal Wkly Rep. 2020;69(20):630–631. - PubMed
    1. Santoli J.M., Lindley M.C., DeSilva M.B., Kharbanda E.O., Daley M.F., Galloway L., et al. Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration — United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(19):591–593. - PubMed
    1. Murthy BP, Zell E, Kirtland K, Jones-Jack N, Harris L, Sprague C, et al. Impact of the COVID-19 pandemic on adminsitration of selected routine childhood and adolescent vaccinations - 10 U.S. Jurisdictions, March-September 2020. MMWR Morb Mortal Wkly Rep. 2021;70(23). - PMC - PubMed
    1. Langdon-Embry M., Papadouka V., Cheng I., Almashhadani M., Ternier A., Zucker J.R. Notes from the Field: Rebound in Routine Childhood Vaccine Administration Following Decline During the COVID-19 Pandemic — New York City, March 1–June 27, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(30):999–1001. - PMC - PubMed
    1. Bode SM, Gowda C, Mangini M, Kemper AR. COVID-19 and Primary Measles Vaccination Rates in a Large Primary Care Network. Pediatrics. 2021;147(1). Epub 2020/11/21. doi: 10.1542/peds.2020-035576. PubMed PMID: 33214332. - PubMed

Publication types