Vaccination Coverage by Age 24 Months Among Children Born During 2018-2019 - National Immunization Survey-Child, United States, 2019-2021

Abstract

Millions of young children are vaccinated safely in the United States each year against a variety of potentially dangerous infectious diseases (1). The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination against 14 diseases during the first 24 months of life* (2). This report describes vaccination coverage by age 24 months using data from the National Immunization Survey-Child (NIS-Child).^† Compared with coverage among children born during 2016-2017, coverage among children born during 2018-2019 increased for a majority of recommended vaccines. Coverage was >90% for ≥3 doses of poliovirus vaccine (93.4%), ≥3 doses of hepatitis B vaccine (HepB) (92.7%), ≥1 dose of measles, mumps, and rubella vaccine (MMR) (91.6%), and ≥1 dose of varicella vaccine (VAR) (91.1%); coverage was lowest for ≥2 doses of hepatitis A vaccine (HepA) (47.3%). Vaccination coverage overall was similar or higher among children reaching age 24 months during March 2020 or later (during the COVID-19 pandemic) than among those reaching age 24 months before March 2020 (prepandemic); however, coverage with the combined 7-vaccine series^§ among children living below the federal poverty level or in rural areas decreased by 4-5 percentage points during the pandemic (3). Among children born during 2018-2019, coverage disparities were observed by race and ethnicity, poverty status, health insurance status, and Metropolitan Statistical Area (MSA) residence. Coverage was typically higher among privately insured children than among children with other insurance or no insurance. Persistent disparities by health insurance status indicate the need to improve access to vaccines through the Vaccines for Children (VFC) program.^¶ Providers should review children's histories and recommend needed vaccinations during every clinical encounter and address parental hesitancy to help reduce disparities and ensure that all children are protected from vaccine-preventable diseases.

FIGURE

Estimated vaccination coverage with selected individual vaccines^,†,§,¶,, and a combined vaccine series by age 24 months, by birth year 2011–2019 — National Immunization Survey–Child, United States, 2012–2021 Abbreviations: DTaP = diphtheria, tetanus toxoids, and acellular pertussis vaccine; HepA = hepatitis A vaccine; HepB = hepatitis B vaccine; Hib = Haemophilus influenzae type b conjugate vaccine; MMR = measles, mumps, and rubella vaccine; PCV = pneumococcal conjugate vaccine; VAR = varicella vaccine. Four or more DTaP includes children who might have received diphtheria and tetanus toxoids vaccine or diphtheria, tetanus toxoids, and pertussis vaccine. One or more MMR includes children who might have received measles, mumps, rubella, and varicella combination vaccine. ^§ Hib full series: primary series and booster dose, which includes receipt of ≥3 or ≥4 doses, depending on product type received. ^¶ HepB birth dose = 1 dose HepB administered from birth through age 3 days. ** Rotavirus vaccination includes ≥2 doses of Rotarix monovalent rotavirus vaccine, or ≥3 doses of RotaTeq pentavalent rotavirus vaccine. The maximum age for the final rotavirus dose is 8 months, 0 days. ^†† Influenza vaccine doses must be administered ≥24 days apart (4 weeks with a 4-day grace period); doses could have been received during two influenza seasons. ^§§ The combined 7-vaccine series (4:3:1:3:3:1:4) includes ≥4 doses of DTaP, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, the full series of Hib (≥3 or ≥4 doses, depending on product type), ≥3 doses of HepB, ≥1 dose of VAR, and ≥4 doses of PCV. ^¶¶ Includes vaccinations received before age 24 months, except for the HepB birth dose, rotavirus vaccination, and ≥2 HepA doses by age 35 months. For all vaccines except the HepB birth dose and rotavirus vaccination, the Kaplan-Meier method was used to estimate vaccination coverage to account for children whose vaccination history was ascertained before age 24 months (35 months for ≥2 HepA doses). *** Children born in 2011 are included in survey years 2012, 2013, and 2014; children born in 2012 are included in survey years 2013, 2014, and 2015; children born in 2013 are included in survey years 2014, 2015, and 2016; children born in 2014 are included in survey years 2015, 2016, and 2017; children born during 2015 are included in survey years 2016, 2017, and 2018; children born in 2016 are included in survey years 2017, 2018, and 2019; children born in 2017 are included in survey years 2018, 2019 and 2020; children born in 2018 are included in survey years 2019 and 2020, and 2021; data for children born during 2019 are considered preliminary and are included in survey years 2020 and 2021 (data from survey year 2022 are not yet available).