A study published recently in the journal Pediatrics showed that in 2019 more than one in six children in the United States aged 19 to 35 months old did not receive all of the doses of vaccines recommended by the U.S. Centers for Disease Control and Prevention (CDC).1
The study examined the vaccination uptake rates of the following seven childhood vaccines: Diphtheria, Tetanus, Acellular Pertussis (DTaP), pneumococcal infections (PCV), Haemophilus influenza type B (Hib), hepatitis B (HepB), polio (IPV), measles, mumps, rubella (MMR) and varicella (VAR).2
One in Six Toddlers Not Vaccinated According to CDC Schedule
Data for this study was collected using public-use National Immunization Survey-Child (NIS-Child) data collected in 2019. With respect to the results of the study, children were classified in one of three mutually exclusive vaccination patterns as follows: (1) completed the combined seven childhood vaccine series; (2) did not initiate more than one of the seven vaccines (i.e. selective vaccination as well as unvaccinated children who did not get any vaccines); or (3) initiated all series but did not complete more than one multi-dose series (i.e. missing more than one dose(s) from the DTaP, PCV, Hib, HepB, and IPV series).3
The study found that 72.9 percent of toddlers completed the combined seven vaccine series; 9.9 percent had not initiated one or more of the seven vaccines, of which 1.1 percent were completely unvaccinated; and 17.2 percent—equivalent to one in every six toddlers— initiated but did not complete one or multiple multi-dose vaccine series.4
Some researchers have stated that this is a trend that has been occurring prior to the COVID-19 pandemic. Nathaniel Beers, MD, executive vice president of community and population health at Children’s National Hospital in Washington, DC stated:
I think certainly during the pandemic, we’ve seen actually worsening of this trend and have been doing a lot of work in the last year in particular to across the field of pediatrics to ensure that we were addressing the worsening vaccination rates beyond the those that were highlighted in the study that was published.5
Researchers Speculate Lack of Access Issues May Explain Why Toddlers Not “Fully” Vaccinated
One of the limitations of the study mentioned by the researchers was that the reasons behind the skipped doses and vaccines were not collected as part of the study. However, researchers are using the associations in the study to speculate why some toddlers are not being fully vaccinated.6
Sarah Michels, MPH, lead author and epidemiologist at the University of Montana Center for Population Health Research, said:
A lot of the recent research and recent population-based studies on vaccination coverage has focused on parental hesitancy, but this study and these findings suggest that logistical and structural barriers to vaccinations persist and are a larger contributor to low vaccination coverage.7
Logistical barriers meaning, irregular fragmented childcare, lack of reminders prompting parents and caregivers to bring their child in for their booster doses, other pragmatic challenges to scheduling appointments or accessing immunization providers.7
The study did not take into account other factors that may result in toddlers not being vaccinated according to CDC guidelines, such as experiences with adverse reactions to previous vaccinations; families moving to other states to avoid vaccine mandates; or parents unwilling to give their children multiple vaccines on the same day and choosing to use delayed vaccine schedules.
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1 Michels S et al. Failure to Complete Multidose Vaccine Series in Early Childhood. Pediatrics Aug. 1, 2023; 152(2): e2022059844.
2 Kekatos M, Dutta S. 1 in 6 toddlers have not completed childhood vaccine series, study finds. ABC News July 27, 2023.
3 Michels S et al. Failure to Complete Multidose Vaccine Series in Early Childhood. Pediatrics Aug. 1, 2023; 152(2): e2022059844.
5 Kekatos M, Dutta S. 1 in 6 toddlers have not completed childhood vaccine series, study finds. ABC News July 27, 2023.
6 Rudy M. Many young kids are not getting ‘life-saving’ vaccines, study finds: ‘Concerning trend’. Fox News July 26, 2023.
7 Kekatos M, Dutta S. 1 in 6 toddlers have not completed childhood vaccine series, study finds. ABC News July 27, 2023.