Top 5 Takeaways

1. High Coverage for Most Vaccines: Coverage exceeded 90% for ≥3 doses of poliovirus vaccine, ≥3 doses of HepB, ≥1 dose of MMR, and ≥1 dose of VAR among children born in 2017 and 2018.
2. Lowest Coverage for Influenza Vaccine: The lowest coverage was for ≥2 doses of influenza vaccine at 60.6%, although this was an increase from previous years.
3. Disparities in Coverage: Significant disparities in vaccination coverage were observed based on health insurance status, race/ethnicity, and poverty level, with uninsured children and those living below the poverty level having lower coverage.
4. Impact of Socioeconomic Factors: Children who were Black, Hispanic, or living below the poverty level had lower vaccination coverage compared to their White or more affluent counterparts.
5. Need for Equity in Vaccination: Persistent disparities highlight the need for improved efforts to achieve equity in the national childhood vaccination program.

Original Article Author and Citation

Corresponding Author

Holly A. Hill, hhill@cdc.gov

Suggested Citation

Hill HA, Yankey D, Elam-Evans LD, Singleton JA, Sterrett N. Vaccination Coverage by Age 24 Months Among Children Born in 2017 and 2018 — National Immunization Survey-Child, United States, 2018–2020. MMWR Morb Mortal Wkly Rep 2021;70:1435–1440. DOI: http://dx.doi.org/10.15585/mmwr.mm7041a1

Summary

This report analyzes vaccination coverage by age 24 months among children born in 2017 and 2018 using data from the National Immunization Survey-Child (NIS-Child). The study found that coverage was highest for poliovirus, HepB, MMR, and VAR vaccines, while the lowest coverage was for the influenza vaccine. The report also highlights disparities in vaccination coverage based on health insurance status, race/ethnicity, and poverty level, with uninsured children and those living below the poverty level having significantly lower coverage.

Methods

The NIS-Child is an annual random-digit–dialed mobile telephone survey of parents or guardians of children aged 19–35 months. Data were collected from 29,114 children born in 2017 and 2018. The survey included sociodemographic information and vaccination histories obtained from providers. Coverage estimates were calculated using Kaplan-Meier analysis, and comparisons were made with children born in 2015 and 2016. Statistical significance was assessed using t-tests with p-values <0.05.

Discussion

The findings indicate stable national vaccination coverage with some increases compared to previous years. However, significant disparities in coverage based on socioeconomic factors persist. Children without private insurance, those living below the poverty level, and those of Black or Hispanic ethnicity had lower vaccination rates. The report emphasizes the need for targeted efforts to address these disparities and improve equity in the national childhood vaccination program.

Conclusion

While national vaccination coverage remains high for most vaccines, persistent disparities based on socioeconomic factors highlight the need for improved efforts to achieve equity. Health care providers and parents must work together to ensure all children are protected from vaccine-preventable diseases, especially in the context of potential disruptions due to the COVID-19 pandemic.

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