OBJECTIVES: To evaluate rotavirus (RV), diphtheria, tetanus, and acellular pertussis (DTaP), and pneumococcal conjugate vaccine (PCV) vaccine coverage and factors associated with vaccine uptake from 2018 through 2023.
METHODS: We included infants born between January 1, 2018 and May 31, 2023, with a minimum of 9聽months of enrollment in the first 12聽months of life and at least 1聽medical visit between 9 and 12聽months at 1 of 8 Vaccine Safety Datalink health systems. We evaluated coverage with 2 doses of RV, DTaP, and PCV vaccines at 5聽months and completion of recommended doses by 12聽months. We evaluated associations of patient race, ethnicity, caregiver's primary language, Medicaid, and time period with vaccine uptake.
RESULTS: We included 395鈥�143 infants: 48.4% female; 14.7% non-Hispanic Asian; 5.8% non-Hispanic Black; 34.2% Hispanic; and 20.6% with Medicaid. Coverage for 2 doses of all 3 vaccines at 5聽months was 87.8% (95% CI 86.9-88.7) in February 2020 vs 80.8% (95% CI 79.8-81.8) in October 2023. Vaccine series completion at 12聽months was highest in January 2020 with 92.3% (95% CI 91.6-92.9) vs 89.6% (95% CI 88.8-90.3) in October 2023. Factors associated with lower vaccine uptake included having a caregiver whose primary language was not English or Spanish, non-Hispanic Black race, and Medicaid.
CONCLUSION: Over 3聽years after the COVID-19 pandemic started, coverage for selected routine childhood immunizations remained below prepandemic levels. Demographic factors, which may reflect structural barriers to accessing care, likely affected coverage. Focused interventions are needed to improve vaccine coverage in all populations.
