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Young boy getting vaccine

CDC: Vaccine coverage for young children stable; disparities persist

November 2, 2023

Vaccine coverage for children by 2 years of age has been relatively stable but disparities continue, according to a new study.

“Socioeconomic, demographic, and geographic disparities in vaccination coverage persist; addressing them is important to ensure protection for all children against vaccine-preventable disease,” researchers from the Centers for Disease Control and Prevention (CDC) wrote in a new Morbidity and Mortality Weekly Report.

Children are recommended to receive 15 vaccines by 24 months of age. Researchers analyzed data provided by parents and guardians in the National Immunization Survey-Child data to look at trends in coverage rates. 

They found coverage was similar between children born in 2019 and 2020 compared to those born in 2017 or 2018. There was a 3.3 percentage point increases in hepatitis B birth dose coverage and a 1.5 percentage point increase in children receiving at least one dose of hepatitis A vaccine.

Data from the survey show coverage of

  • 93% for at least three doses of poliovirus vaccine,
  • 92.1% for at least three doses of hepatitis B vaccine,
  • 91.6% for at least one dose of measles, mumps, rubella vaccine,
  • 91.1% for at least one dose of varicella vaccine,
  • 88.4% for at least one dose of hepatitis A vaccine,
  • 82.7% for at least four doses of pneumococcal conjugate vaccine,
  • 81% for at least four doses of diphtheria, tetanus and acellular pertussis vaccine,
  • 79.1% for a full series of Haemophilus influenzae type b (Hib) vaccine,
  • 76.6% for rotavirus vaccine by age 8 months,
  • 69.1% for the combined seven-vaccine series, and
  • 61.3% for at least two doses of influenza vaccine.

About 1% of children were completely unvaccinated by 2 years of age.

Children living below the poverty level, uninsured, using public insurance or living in rural areas tended to have lower vaccine coverage. Children who are Black, Hispanic, American Indian or Alaska Native (AI/AN) had lower coverage for most vaccines compared to White children.

Authors also said they were concerned about low coverage with the Hib vaccine among AI/AN children compared to White children at a time when diseases rates in this population are elevated.

Parents whose children were not fully vaccinated cited barriers such as scheduling, transportation, child care costs and limited of knowledge of vaccine recommendations.

Authors suggested improving vaccination rates through strong recommendations from clinicians, improving awareness of the Vaccines for Children program, utilizing all available vaccine venues and enhancing reminder systems for families.

“Universal and equitable access to vaccination will require overcoming often interrelated economic, logistical, and attitudinal obstacles,” they wrote. 

The CDC recently announced the 2024 immunization schedules will be published online later this month, several months ahead of the usual timeline. They also will be updated more frequently as the timing impacts insurance payment and the ability of certain health care providers to administer immunizations in some states. In addition, health care providers referring to the schedule otherwise may not be aware of recommendations made after its publication. The AAP and numerous other medical organizations have expressed support for updating the schedules more frequently.



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