hib vaccine for infants :: Article CreatorStudy: 17% Of US Children Do Not Finish Vaccine Series
Yesterday in Pediatrics researchers mined vaccine records of 16,365 US children ages 19 to 35 months in 2019 to determine how many complete the seven common multidose vaccine series given in infancy and early childhood. They found 1 in 6 US children had incomplete vaccine series.
Currently the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommends several vaccine series, each consisting of 1 to 4 doses, to protect against 15 diseases in the first 2 years of a child's life.
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The present study surveyed a random sample of US caregivers who provided vaccine records for their children. The main outcome was uptake for the seven series of vaccines deemed most important for preventing childhood illness, which includes diphtheria, tetanus, and acellular pertussis (DTaP, 4 doses), pneumococcal conjugate vaccine (PCV, 4 doses), Haemophilus influenzae type b (Hib, 3–4 doses depending on brand), hepatitis B (HepB, 3 doses), polio (IPV, 3 doses), measles, mumps and rubella (MMR, 1 dose), and varicella (VAR, 1 dose) vaccines.
A total of 72.9% of children completed the entire vaccine series. Four out of seven of the vaccines had complete coverage 90% or greater, which is needed to confer herd immunity (IPV: 92.3%, MMR: 91.8%, HepB: 91.3%, and VAR: 90.9%). But DTaP, PCV, and Hib remained under target, at 83.3%, 82.5%, and 81.0% completion, respectively.
"Non-Hispanic White children, children whose families accessed care at private facilities, firstborn children, and children with private health insurance were more likely to have completed the combined 7-vaccine series," the authors wrote.
According to the authors, non-Hispanic Black children were at greater risk of not completing multidose series as compared with non-Hispanic White children (adjusted prevalence ratio [aPR] 1.28). And children from lower-income households and in rented homes were 25% to 30% more likely to fail to complete multidose vaccine series.
1 In 6 Toddlers Have Not Completed Childhood Vaccine Series, Study Finds
Several routine childhood vaccines require multiple doses to be effective, but a new study finds children are not receiving all of them.
The study, published in the journal Pediatrics Wednesday, found one in six toddlers between ages 19 months and 35 months started the vaccine series but didn't complete it, leaving them vulnerable to serious diseases.
Researchers from several institutions, including the University of Montana, the University of Colorado, Kaiser Permanente Colorado and the Yale School of Public Health, looked at data from the 2019 National Immunization Survey for more than 16,000 children.
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They looked at vaccine series' that protects children from 11 different diseases including diphtheria, tetanus, acellular pertussis, pneumococcal infections, Haemophilus influenzae type B, hepatitis B, polio, measles, mumps, rubella and varicella.
The study found that only 72.9% of toddlers completed the combined 7-vaccine series and 17.2% -- equivalent to one in every six toddlers -- initiated, but did not complete, the one or multiple multi-dose vaccine series.
In this undated stock photo, a gloved doctor applies a bandage to a young patient after an injection.
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What's more, approximately 1.1% of children were completely unvaccinated and 9.9% had not initiated one or more of the seven vaccinations.
Overall we found that 8.5% of U.S. Kids were one dose away from completing the combined 7-vaccine series, which is one of our standard metrics of measuring vaccination coverage," Sara Michels, lead author and epidemiologist at the University of Montana Center for Population Health Research, told ABC News. "If children who were missing only one outstanding dose had received that dose, the U.S. Could have met some of our key national vaccination coverage goals."
Researchers say this is evidence of a trend that has been occurring for years.
"I think the study highlighted a trend that we had been seeing in pediatrics prior to the pandemic," Dr. Nathaniel Beers, executive vice president of community and population health at Children's National Hospital in Washington, D.C., who was not involved in the study, told ABC News.
"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," he added.
Ninety-three percent of kindergarten-age children had received the recommended vaccines, according to a recent report from the Centers for Disease Control and Prevention conducted during the 2021–22 school year.
This is lower than both the 94% coverage reported during the 2020–21 school year, and the 95% coverage reported during the 2019–20 school year, prior to the pandemic.
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Researchers identified factors for why some children started, but did not complete, the vaccine series including families moving across state lines, number of children in household and lack of health insurance.
"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," Michels said. "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."
"Certainly, maintaining and sharing adequately of medical records creates barriers to ensuring adequate care," when people move across state lines, Beers added.
He continued, "We know people have been more transient for work or other reasons, and that certainly creates gaps in care for kids, particularly young kids who have frequent immunization needs in the first three years of life."
Beers said vaccine hesitancy, which is defined as delaying or refusing vaccination despite their widespread availability, is a contributing factor.
In 2019, the World Health Organization called vaccine hesitancy one of the top 10 threats to public health because it "threatens to reverse progress made in tackling vaccine-preventable diseases."
In this undated stock photo, a young patient receives a vaccine injection from a doctor.
STOCK PHOTO/Getty Images
We've seen vaccine hesitancy play a role in measles outbreaks in the U.S. Including a recent outbreak in Columbus, Ohio, where 85 children were infected.
"There's two components that are why we encourage people to get vaccinated," Beers said. "So, it's preventing the disease in yourself, but also preventing the spread of disease in the community."
This helps create herd immunity, in which enough people have been vaccinated or are immune to disease, which then becomes unable to spread.
To help increase rates, the team re-highlighted some methods including more widespread adoption of systems that remind parents their child is due for or is late receiving their next vaccine dose, expanding vaccines to more places outside of a primary care setting, as well as speaking to hesitant parents.
"We certainly [need to] continue to work on vaccine education, making sure that we are providing that for patients and families," Beers said. "Even for those families who have previously rejected the opportunity to get vaccines, making sure that we continue to offer them the opportunity to start those, and to continue that dialogue, because people do change their minds and continue to get good high-quality information is an important piece of helping people make a decision to move forward with vaccinations."
Michels said she hopes providers use the findings to implement vaccine interventions at the clinic level.
Many Young Kids Are Not Getting 'life-saving' Vaccines, Study Finds: 'Concerning Trend'
More than one in six toddlers are not getting all of the doses of the recommended early childhood vaccines, according to a new study published in the journal Pediatrics on July 25.
A team of researchers from the University of Montana analyzed vaccination records from 2019 for several childhood immunizations — measles, polio, tetanus, diphtheria, pertussis (whooping cough), Hepatitis B, mumps, rubella, Haemophilus influenzae type b, varicella and pneumococcal infections — for more than 16,300 U.S. Toddlers between 19 and 35 months of age.
Most of the vaccines require three or four doses for full protection — but more than 27% of the children had not received the entire series.
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Nearly 73% of them completed the full series of vaccines, nearly 10% did not start any of the series — and 17.2% started but did not complete one or more of the series, the study said.
"Increased focus on strategies to encourage multi-dose series completion is needed to optimize protection from preventable diseases and achieve vaccination coverage goals," the study authors wrote.
More than one in six toddlers are not getting all of the doses of the recommended early childhood vaccines, according to a new study. (iStock)
The biggest risk factors of vaccine non-compliance included moving across state lines, the number of children in the household and a lack of insurance coverage, according to the study findings in Pediatrics.
Lowered household income, living in a rented home, and race and ethnicity were also factors.
Black children were more likely to have not completed a full vaccine series than White children, the study found.
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Dr. Shana Johnson, a physical medicine and rehabilitation physician in Scottsdale, Arizona, was not involved in the University of Montana study but reviewed the findings.
"These findings highlight well-known issues in the U.S. Health care system, including fragmented care with poor coordination across providers, a complex and difficult insurance system, and unequal access to health care," she told Fox News Digital.
"Increased focus on strategies to encourage multi-dose series completion is needed to optimize protection from preventable diseases and achieve vaccination coverage goals," the study authors wrote. (iStock)
On a positive note, Johnson pointed out that 8.4% of the children needed only one additional vaccine dose to complete the series.
"If the children who were missing only one dose from the vaccine series had received it, the U.S. Would have met the Healthy People 2020 goal of 80% coverage for vaccine series completion," she said.
"This is a worsening from prior CDC statistics of over 90% compliance, which is what you need for herd immunity." — Dr. Marc Siegel
(The Healthy People 2020 goal was an initiative established by the U.S. Department of Health and Human Services.)
One limitation of the study, noted by the authors, is that the actual reasons behind the missed doses were not collected.
"The associations provide important insights, but the actual reasons are important data points," Johnson said.
'A concerning trend'
Dr. Marc Siegel, professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, also reviewed the study findings and said they mark "a concerning trend."
"This is occurring especially in socioeconomic disadvantaged areas and involves diseases that are highly contagious and could easily reappear," Dr. Marc Siegel said. (iStock)
"This is occurring especially in socioeconomic disadvantaged areas and involves diseases that are highly contagious and could easily reappear," he told Fox News Digital.
"This is a worsening from prior CDC statistics of over 90% compliance, which is what you need for herd immunity," he also said.
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Josh Sharfstein, a pediatrician who is also vice dean of public health at Johns Hopkins in Maryland, told Dr. Siegel last week that he is "very concerned" that the "anti-vaxx movement with COVID" is spilling over to resistance of life-saving childhood vaccines or people not taking them at the right times for full effectiveness.
"I think he is quite right to be concerned," Siegel said.
Boosting childhood vaccinations
The study authors recommended increasing support for children from low-income families or racial minority groups, who are "most at-risk for infectious diseases and poorer outcomes due to social and environmental determinants of health."
The study authors recommended increasing support for children from low-income families or racial minority groups. (iStock)
Some suggested aids include greater use of reminder systems, flexible scheduling and pre-visit planning.
The Centers for Disease Control and Prevention (CDC) also offers a Vaccines For Children (VFC) program, which provides free vaccines to children who may not get immunized due to financial constraints.
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"Renewed efforts to better support timely completion of multi-dose vaccine series in early childhood are needed to achieve vaccination coverage goals," the study authors wrote.
Melissa Rudy is health editor and a member of the lifestyle team at Fox News Digital.
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