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Association of the COVID-19 Pandemic With Routine Childhood Vaccination Rates and Proportion Up to Date With Vaccinations Across 8 US Health Systems in the Vaccine Safety Datalink.
DeSilva, Malini B; Haapala, Jacob; Vazquez-Benitez, Gabriela; Daley, Matthew F; Nordin, James D; Klein, Nicola P; Henninger, Michelle L; Williams, Joshua T B; Hambidge, Simon J; Jackson, Michael L; Donahue, James G; Qian, Lei; Lindley, Megan C; Gee, Julianne; Weintraub, Eric S; Kharbanda, Elyse O.
  • DeSilva MB; HealthPartners Institute, Minneapolis, Minnesota.
  • Haapala J; HealthPartners Institute, Minneapolis, Minnesota.
  • Vazquez-Benitez G; HealthPartners Institute, Minneapolis, Minnesota.
  • Daley MF; Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
  • Nordin JD; HealthPartners Institute, Minneapolis, Minnesota.
  • Klein NP; Kaiser Permanente Vaccine Study Center, Oakland, California.
  • Henninger ML; Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
  • Williams JTB; Ambulatory Care Services, Denver Health, Denver, Colorado.
  • Hambidge SJ; Ambulatory Care Services, Denver Health, Denver, Colorado.
  • Jackson ML; Kaiser Permanente Washington, Seattle.
  • Donahue JG; Marshfield Clinic Research Institute, Marshfield, Wisconsin.
  • Qian L; Kaiser Permanente Southern California, Pasadena.
  • Lindley MC; Immunization Services Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Gee J; Immunization Safety Office, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Weintraub ES; Immunization Safety Office, US Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Kharbanda EO; HealthPartners Institute, Minneapolis, Minnesota.
JAMA Pediatr ; 176(1): 68-77, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1453520
ABSTRACT
Importance The COVID-19 pandemic has affected routine vaccine delivery in the US and globally. The magnitude of these disruptions and their association with childhood vaccination coverage are unclear.

Objectives:

To compare trends in pediatric vaccination before and during the pandemic and to evaluate the proportion of children up to date (UTD) with vaccinations by age, race, and ethnicity. Design, Setting, and

Participants:

This surveillance study used a prepandemic-postpandemic control design with data from 8 health systems in California, Oregon, Washington, Colorado, Minnesota, and Wisconsin in the Vaccine Safety Datalink. Children from age groups younger than 24 months and 4 to 6, 11 to 13, and 16 to 18 years were included if they had at least 1 week of health system enrollment from January 5, 2020, through October 3, 2020, over periods before the US COVID-19 pandemic (January 5, 2020, through March 14, 2020), during age-limited preventive care (March 15, 2020, through May 16, 2020), and during expanded primary care (May 17, 2020, through October 3, 2020). These individuals were compared with those enrolled during analogous weeks in 2019. Exposures This study evaluated UTD status among children reaching specific ages in February, May, and September 2020, compared with those reaching these ages in 2019. Main Outcomes and

Measures:

Weekly vaccination rates for routine age-specific vaccines and the proportion of children UTD for all age-specific recommended vaccines.

Results:

Of 1 399 708 children in 2019 and 1 402 227 in 2020, 1 371 718 were female (49.0%) and 1 429 979 were male (51.0%); 334 216 Asian individuals (11.9%), 900 226 were Hispanic individuals (32.1%), and 201 619 non-Hispanic Black individuals (7.2%). Compared with the prepandemic period and 2019, the age-limited preventive care period was associated with lower weekly vaccination rates, with ratios of rate ratios of 0.82 (95% CI, 0.80-0.85) among those younger than 24 months, 0.18 (95% CI, 0.16-0.20) among those aged 4 to 6 years, 0.16 (95% CI, 0.14-0.17) among those aged 11 to 13 years, and 0.10 (95% CI, 0.08-0.13) among those aged 16 to 18 years. Vaccination rates during expanded primary care remained lower for most ages (ratios of rate ratios <24 months, 0.96 [95% CI, 0.93-0.98]; 11-13 years, 0.81 [95% CI, 0.76-0.86]; 16-18 years, 0.57 [95% CI, 0.51-0.63]). In September 2020, 74% (95% CI, 73%-76%) of infants aged 7 months and 57% (95% CI, 56%-58%) of infants aged 18 months were UTD vs 81% (95% CI, 80%-82%) and 61% (95% CI, 60%-62%), respectively, in September 2019. The proportion UTD was lowest in non-Hispanic Black children across most age groups, both during and prior to the COVID-19 pandemic (eg, in May 2019, 70% [95% CI, 64%-75%] of non-Hispanic Black infants aged 7 months were UTD vs 82% [95% CI, 81%-83%] in all infants aged 7 months combined). Conclusions and Relevance As of September 2020, childhood vaccination rates and the proportion who were UTD remained lower than 2019 levels. Interventions are needed to promote catch-up vaccination, particularly in populations at risk for underimmunization.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / Vaccination / Vaccination Coverage / COVID-19 Type of study: Randomized controlled trials / Risk factors Topics: Vaccines Limits: Child / Female / Humans / Male Language: English Journal: JAMA Pediatr Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / Vaccination / Vaccination Coverage / COVID-19 Type of study: Randomized controlled trials / Risk factors Topics: Vaccines Limits: Child / Female / Humans / Male Language: English Journal: JAMA Pediatr Year: 2022 Document Type: Article