Among military children, there has been an improvement in vaccine completion and timeliness, but the risk for noncompletion is higher among children born to younger parents and those with a well-child care location change, according to a study published online Sept. 19 in Pediatrics.

Celeste J. Romano, from the Naval Health Research Center in San Diego, and colleagues identified children born at military hospitals from 2010 through 2019 and examined vaccine completion and timeliness for diphtheria, tetanus, and pertussis; polio; measles, mumps, and rubella; hepatitis B; Haemophilus influenzae type b; varicella; and pneumococcal conjugate individually and as a combined seven-vaccine series through 24 months.

The researchers found that 74.4 percent of 275,967 children completed the combined seven-vaccine series; delays occurred in 36.2 percent of those who completed the series. Among children born in 2016 and 2017, completion peaked at 78.7 percent. Completion was lowest for rotavirus (77.5 percent); diphtheria, tetanus, and pertussis (83.1 percent); Haemophilus influenzae type b (86.6 percent); and pneumococcal conjugate (88.4 percent). Children born to younger parents had a higher risk for noncompletion (adjusted risk ratio, 1.33), as did children with a well-child care location change (adjusted risk ratio, 1.10). Parallel risk was seen for delays and noncompletion.

“Identified patterns in undervaccination indicate continued challenges to immunization services delivery,” the authors write. “Further work is needed to address these barriers to vaccination and improve access to care.”

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