Children born in 2020 to 2021 had lower coverage with nearly all childhood vaccines recommended by age 24 months than those born in 2018 and 2019, according to research published in the Sep. 26 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Holly A. Hill, M.D., Ph.D., from the CDC in Atlanta, and colleagues estimated coverage of childhood vaccines recommended by the Advisory Committee on Immunization Practices among U.S. children by the age of 24 months using data from the National Immunization Survey-Child.

The researchers found that children born in 2020 and 2021 had lower coverage for nearly all vaccines than those born in 2018 and 2019, with declines varying from 1.3 to 7.8 percentage points. Such widespread declines in routine childhood vaccination coverage have not been seen for earlier birth cohorts.

Among children born during 2020 to 2021, coverage varied by race and ethnicity, health insurance status, poverty status, urbanicity, and jurisdiction. Coverage with four of the 17 vaccine measures was lower among non-Hispanic Black or African American children, Hispanic or Latino children, and non-Hispanic American Indian or Alaska Native children, compared with non-Hispanic white children.

Those covered by Medicaid or other nonprivate insurance, uninsured children, children living below the federal poverty level, and children living in rural areas generally had lower coverage. There was wide variation noted in coverage by jurisdiction, especially coverage with two or more doses of influenza vaccine.

“Addressing financial barriers and other access issues along with vaccine hesitancy and misinformation concerns is important to increasing vaccination coverage and reducing disparities,” the authors write.

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