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Study finds persistent childhood vaccination disparities linked to socioeconomic factors in U.S.

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Study Reveals Trends and Disparities in U.S. Childhood Vaccination

A new analysis of national data shows that while overall childhood vaccination rates have improved over the past decade, significant disparities linked to social and economic factors persist.

Key Study Details

  • Publication: JMIR Public Health Surveillance
  • Data Source: National Immunization Survey-Child data from 2010 to 2023.
  • Focus: Researchers from Indiana University examined provider-verified vaccination coverage among children aged 19 to 35 months.
  • Assessment: The study evaluated up-to-date status for individual vaccines and completion of a combined seven-vaccine series.

Overall Trends and Disparities

Combined seven-vaccine series completion rates increased from approximately 71% in 2010 to nearly 77% in 2023.

Despite this overall improvement, the analysis identified persistent gaps in coverage associated with several sociodemographic factors:

  • Maternal education level
  • Household income-to-poverty ratio
  • Insurance status
  • Interview language
  • Geographic region

Insurance coverage and maternal education became stronger predictors of vaccination status in the later years of the study period.

The study also found that older children (closer to 35 months) were consistently more likely to be fully vaccinated than younger children (19-23 months). This age-based gap widened after the COVID-19 pandemic. Additionally, larger household size was associated with lower vaccination rates throughout the study period.

Vaccine-Specific Patterns

Coverage rates varied significantly between different immunizations:

  • High Coverage: Core vaccines, including polio and measles-mumps-rubella (MMR), maintained coverage above 90% throughout the entire study period.
  • Improved Coverage: Influenza vaccination rates improved from 66% in 2010 to 78% in 2022 before plateauing.
  • Lower Coverage: Hepatitis A vaccination uptake remained comparatively low.
  • Recent Declines: Rotavirus and influenza vaccination showed declines in the 2022-2023 period.

Study Methodology and Context

The research used a cross-sectional design, analyzing data from each year separately to assess trends and pandemic-related shifts.

The authors state that the cross-sectional design shows associations rather than causation between sociodemographic factors and vaccination status.

The study was limited to provider-verified immunization records, which the authors note may introduce selection bias. Estimates from the post-2020 period should also be interpreted with caution due to changes in healthcare provider participation and survey response patterns during and after the pandemic.

This work builds on previous research linking childhood vaccination to social determinants of health, such as income, education, and access to care. The authors note that most prior studies used pooled datasets, shorter time frames, or focused on individual vaccines.