Child Vaccination Rates Lower in 2020 Than 2019, Linked To COVID-19 Pandemic

The number of recommended vaccine doses administered to children, including measles vaccine, decreased significantly after the national state of emergency was declared in response to the COVID-19 pandemic, according to a study published in Pediatrics. The decrease was lower in children under 2 years of age and recovered quickly in that group, but it remained persistent in older children.

Researchers determined vaccination trends by assessing the uptake and coverage for recommended vaccines among nearly 1 million children from birth to 18 years of age from January 2020 through August 2020, comparing those data with the same period in 2019. Coverage measures the proportion of children vaccinated at specific ages, whereas uptake is the total number of children getting vaccinated. According to the study, vaccinations did not return to pre-pandemic levels in most age groups, resulting in a continued decline of vaccine coverage after uptake recovered.

“When vaccination rates decline, we worry about an increase in vaccine-preventable diseases that can be harmful to children,” said Bradley Ackerson, MD, the study’s lead author, in a press release. “Also, we know there has been a reduction in childhood vaccinations worldwide, and as COVID-19 restrictions are relaxed, there will be an increased risk of outbreaks due to vaccine-preventable diseases among children returning from outside the United States, unless children here are vaccinated.”

The study examined measles vaccination rates separately, as measles is particularly contagious and causes severe disease across all age groups. After an initial decline in measles vaccinations of up to 93% across children aged 2 to 18 years during the pandemic, measles vaccinations partially recovered, but remained lower in 2020 than in 2019. Additionally, although measles vaccination coverage was unchanged in the 7-year-old patients, there was a significant decrease in measles vaccination coverage among 16-month-old patients that worsened over time.

“While the severe decrease in measles vaccine uptake among children improved, measles vaccine uptake remained substantially reduced, so the population of unvaccinated children is continuing to grow,” Ackerson said in the release. “The decrease in measles vaccine uptake is very concerning as even a 2% to 5% reduction in measles vaccination coverage is projected to result in exponential increases in measles outbreaks.”

At Kaiser Permanente in Southern California, measures are being taken by clinicians to address childhood vaccination concerns, including contacting members whose children are due for vaccination and providing reassurance about safety measures being taken for vaccination visits, according to the press release. Masking, distancing, and hygiene measures have been implemented, drive-through vaccinations are being provided at certain facilities, and sick visits are separated from well visits by location and time.


Child vaccination rates declined during COVID-19 pandemic [news release]. April 15, 2021. Accessed April 19, 2021.