Vaccine timeliness improves among infants, but not equally
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Key takeaways:
- The percentage of children who were vaccinated on time increased significantly from 2011 to 2021.
- However, rates of improvement were lower among lower income families and children without private insurance.
The proportion of infants who were vaccinated on time in the United States increased from 2011 to 2021, but did not improve equally among all groups, according to a study.
Rates of on-time vaccination did not increase as much among children from lower income families and children not covered by private insurance, researchers reported.
The findings were first presented at last year’s Pediatric Academic Societies Annual Meeting and have now been published in JAMA Network Open, with an additional year of results.
“Getting vaccinated on time is important for disease protection, particularly for infants and young children,” Sophia R. Newcomer, PhD, MPH, an associate professor at the University of Montana School of Public and Community Health Sciences, told Healio. “In this study, we quantified the percentage of U.S. infants who got their recommended vaccinations on time, and we looked to see if there were important trends in on-time vaccination.”
Newcomer and colleagues analyzed data from the CDC’s National Immunization Survey – Child, an annual survey that collects vaccination histories for children aged between 19 to 35 months. They compared the age when infants received vaccines with recommendations made by the CDC’s Advisory Committee on Immunization Practices.
“We then quantified the percentage of children who received all doses on time from seven routine vaccine series,” Newcomer said. “We looked to see if there were trends in on-time vaccination from the 2011 survey through the 2021 survey, and whether trends in on-time vaccination differed by socioeconomic factors, including family income and the child’s health insurance status.”
Among 179,154 children, 31.4% lived above the federal poverty level with more than $75,000 in annual family income, 32.4% lived at or above the poverty level with $75,000 or less in annual family income and 30.2% lived below the poverty level. The surveys examined whether children received the combined seven-vaccine childhood series, which includes four doses of diphtheria-tetanus-acellular pertussis vaccine, three doses of inactivated poliovirus vaccine, one dose of measles-mumps-rubella vaccine, three doses of hepatitis B vaccine, either three or four doses of Haemophilus influenzae type b vaccine, one dose of varicella vaccine and four doses of pneumococcal conjugate vaccine.
According to the researchers, the median average days spent undervaccinated with the combined seven-vaccine series in the U.S. decreased from 22.3 in the 2011 survey to 11.9 in the 2021 survey, with the prevalence of on-time receipt increasing from 22.5% to 35.6% in that time.
“We were happy to see that overall, the percentage of children who got their vaccinations on time increased significantly from the 2011 survey to the 2021 survey,” Newcomer said. “This was an important finding, showing that adherence to national recommendations for when infants should get vaccinated has been steadily improving over time. This means that more providers are recommending vaccines, and more parents are accepting vaccines, at the right ages.”
Children with more than $75,000 in annual family income had a 4.6% (95% CI, 4%-5.2%) mean annual increase in on-time vaccination. By comparison, the mean annual increase was 2.8% (95% CI, 2%-3.6%) for children living at or above the poverty level and 2% (95% CI, 1%-3%) for children living below the poverty level.
“We saw that socioeconomic disparities in on-time vaccination [have] widened over time, indicating that challenges remain for lower-income and uninsured families in accessing routine preventive health care, like vaccinations,” Newcomer said, adding that the findings suggest there continue to be barriers to accessing timely health care for lower income children.
“Future efforts should focus on facilitating vaccine access for these families, including making vaccination appointments easy to get, and clinics proactively reaching out to let parents know that their children are due for vaccines,” Newcomer said.
“On-time vaccination is important for infectious disease prevention both at the individual and community levels. While our study used national data, I think future work should track vaccination timeliness at more local levels to identify where improvements are needed.”
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