COVID-19 and Completion of Select Routine Childhood Vaccinations

Abstract

Objectives: To evaluate rotavirus (RV), diphtheria, tetanus, and acellular pertussis (DTaP), and pneumococcal conjugate vaccine (PCV) vaccine coverage and factors associated with vaccine uptake from 2018 through 2023.

Methods: We included infants born between January 1, 2018 and May 31, 2023, with a minimum of 9 months of enrollment in the first 12 months of life and at least 1 medical visit between 9 and 12 months at 1 of 8 Vaccine Safety Datalink health systems. We evaluated coverage with 2 doses of RV, DTaP, and PCV vaccines at 5 months and completion of recommended doses by 12 months. We evaluated associations of patient race, ethnicity, caregiver's primary language, Medicaid, and time period with vaccine uptake.

Results: We included 395 143 infants: 48.4% female; 14.7% non-Hispanic Asian; 5.8% non-Hispanic Black; 34.2% Hispanic; and 20.6% with Medicaid. Coverage for 2 doses of all 3 vaccines at 5 months was 87.8% (95% CI 86.9-88.7) in February 2020 vs 80.8% (95% CI 79.8-81.8) in October 2023. Vaccine series completion at 12 months was highest in January 2020 with 92.3% (95% CI 91.6-92.9) vs 89.6% (95% CI 88.8-90.3) in October 2023. Factors associated with lower vaccine uptake included having a caregiver whose primary language was not English or Spanish, non-Hispanic Black race, and Medicaid.

Conclusion: Over 3 years after the COVID-19 pandemic started, coverage for selected routine childhood immunizations remained below prepandemic levels. Demographic factors, which may reflect structural barriers to accessing care, likely affected coverage. Focused interventions are needed to improve vaccine coverage in all populations.