Study Finds Mixed Results on Early Childhood Vaccination

On the positive side, the percentage of young children who received the recommended doses in the series increased from 68.4% in 2012, the Healthy People 2020 initiative’s baseline, to 72.9% in 2019.

In addition, four vaccines in the series had coverage that exceeded the initiative’s 90% target rate, with polio the highest at 92.3%.

And while coverage rates for the remaining three vaccines (DTaP, Hib and pneumococcal disease) did not meet Healthy People 2020 targets, they were all slightly higher than the baseline.

Finally, the researchers noted that 8.4% of children in the study population needed only one additional dose from a multidose vaccine series to have completed the combined seven-vaccine series.

Recommendations to Improve Coverage

The authors suggested several tactics to improve vaccine series completion, including giving reminders, administering vaccines outside of the primary care setting, offering flexible scheduling, using automated prompts at the point of care, and planning ahead of scheduled visits.

At the same time, they observed that vaccine coverage gaps still exist, especially in lower-income households and for those who lack health insurance. In these cases, the authors recommended helping to connect patients with the federal Vaccines for Children program and coordinating insurance enrollment for eligible uninsured children.

For children who have moved or have incomplete or missing immunization records, the authors also recommended relatively new efforts, such as the use of immunization coordinators from state and local health departments, and increased communication among state immunization information systems.

“Optimizing timely multidose series completion in the first two years of life is necessary for disease protection and durable immunity for individuals, as well as to develop and maintain herd immunity at a population level,” the authors concluded. “Our findings regarding socioeconomic and racial and ethnic disparities indicate that established strategies for facilitating multidose series completion, such as reminder-recall are not reaching all communities. Renewed efforts to better support timely completion of multidose vaccine series in early childhood are needed to achieve vaccination coverage goals.”

AAFP Resources

The Academy has a plethora of fact sheets and guidance documents to assist family physicians in improving childhood vaccination rates, including

Additional resources, such as the latest immunization schedules, CME activities and more are available at the Academy’s Immunizations and Vaccines webpage and familydoctor.org’s Immunizations webpage.