Vaccine coverage lowest among children who were uninsured or covered by Medicaid compared with children who had private insurance.
Vaccine coverage among young children for recommended immunizations remains stable and high, but several disparities were found, according to the CDC’s Morbidity and Mortality Weekly Report.
Based on data from the 2016 National Immunization Survey-Child (NIS-Child) of children aged 19-35 months old in the United States, coverage remained high for the poliovirus vaccine (91.9%), varicella vaccine (90.6%), and hepatitis B vaccine (90.5%). However, coverage remained below 90% for the hepatitis A vaccine (60.6%), the combined 7-vaccine series (70.7%), the hepatitis B birth dose (71.1%), and the completed series of rotavirus vaccine (74.1%).
A small percentage, 0.8% of children, received no vaccinations.
An analysis of trends by month and year of birth found no change in coverage by 2 years of age among children included in combined data from the 2015 and 2016 NIS-Child.
However, the researchers found several disparities in coverage. Black children had lower coverage rates than white children for some vaccines, including DTaP, the primary and full series of Haemophilus influenzae type b (Hib), pneumococcal conjugate vaccine (PCV), and hepatitis A. Other disparities noted include lower coverage of most vaccines among children living below the federal poverty level, in which the largest gaps were seen for the rotavirus vaccine, PCV doses, the 7-vaccine series, and the full series of Hib.
Vaccine coverage was also lowest in children who were uninsured or covered by Medicaid, when compared with children who had private insurance. Large gaps were noted between these two groups with respect to rotavirus vaccination, hepatitis B vaccination, and PCV.
These disparities indicate that improvements are needed in access to and delivery of age-appropriate immunization to all children, regardless of insurance or financial status, the researchers concluded. The researchers recommended that health care providers use evidence-based strategies, such as provider reminders, standing orders to provide vaccination whenever appropriate, and immunization information systems.
Hill HA, Elam-Evans LD, Yankey D, et al. Vaccination coverage among children aged 19-35 months — United States 2016. MMWR. November 3, 2017. 66(43);1171-1177. https://www.cdc.gov/mmwr/volumes/66/wr/mm6643a3.htm?s_cid=mm6643a3_w