Routine Pediatric Vaccinations Continue to Lag Amid COVID-19 Pandemic


There was a marked decline in child and adolescent routine vaccine administration during the COVID-19 pandemic between March and September 2020; these vaccination rates have continued to lag behind.

Study results published by the CDC on June 11, 2021, emphasized that pediatric vaccine administration rates continue to lag behind prepandemic levels. The study was conducted from March through June 2020 over a 6-month period, which was subdivided into 2 time periods. The first was March through May 2020 and the second was June through September 2020.

Investigators analyzed immunization information data taken from 10 jurisdictions in the United States, including New York City, Michigan, Wisconsin, and Iowa. The findings revealed there were fewer administered doses of routine childhood and adolescence vaccines in all 10 jurisdictions from March through September 2020, during the COVID-19 pandemic compared with those recorded during the same period in 2018 and 2019.

There was a substantial decline from March through May 2020, when many jurisdictions enacted stay-at-home orders. Some of the vaccines that were tracked included diphtheria, tetanus, pertussis, measles, mumps, and rubella, and human papillomavirus vaccines. Vaccine doses administered declined during the COVID-19 pandemic from between 15.7% to 71.3%. The older age group experienced a steeper decline in vaccines administered when compared with the younger-aged children.

From June through September 2020, after most stay-at-home orders had been lifted, the number of weekly routine pediatric vaccine doses administered increased from the previous 3 months. However, the increase was not sustained, and the number of vaccine doses still declined compared with 2018 and 2019 but at a lesser rate than the 3 months prior. Despite the vaccine administration rebound that occurred, the investigators indicated that the increase was not enough to address the number of catch-up vaccinations needed.

According to the investigators, the first limitation of the study was that vaccination data from only 10 US jurisdictions were analyzed. Therefore, findings might not be as ideal a representation of the United States as possible. The second limitation was that only 1 type of data system was used to analyze the data and there are multiple other data vaccination systems available. Thirdly, the study never scientifically analyzed the specifics regarding the reason for the decrease in the vaccination administration during the COVID-19 pandemic.

The investigators noted several factors may have caused this significant decrease in the amount of routine pediatric vaccines administered. For example, fear of contracting COVID-19 in health care facilities and the community during the pandemic may have prevented some from seeking routine pediatric care for their children. “While families followed public health warnings about going out, an unfortunate result was many missed routine vaccinations.”[1][2]

Vaccine-preventable disease outbreaks can lead not only to morbidity and mortality but also can lead to a loss of in-person learning for the children. When the COVID-19 vaccine becomes available to the pediatric population, the CDC recommends that health care providers should administer the COVID-19 vaccines with other routinely recommended vaccines for pediatric patients who are behind on their routine recommended vaccines. Through a group effort, health care providers should assess the status of all pediatric patients including adolescents, and contact those who are behind in their vaccination schedule to ensure they are caught up with their current vaccinations.

In August 2020, Alex Azar, MD, former secretary of the US Department of Health and Human Services [JB1]used emergency powers during the COVID-19 pandemic to authorize licensed pharmacists in the United States to administer routine vaccinations to children. This move was to prevent future outbreaks of measles and other preventable diseases and to help prevent the falling vaccination rates. “Enabling pharmacists to expand their offering of vaccination is welcome news for families and young patients, for whom neighborhood pharmacists are often the most accessible health care providers,” National Community Pharmacists Association CEO B. Douglas Hoey, MBA, RPh, said of the action.2


1. Murthy BP, Zell E, Kirtland K, Jones-Jack N, et al. Impact of the COVID-19 pandemic on administration of selected routine childhood and adolescence vaccinations—10 US jurisdictions, March-September 2020. Morbidity and Mortality Weekly Report. Doi: icon

2. Blank C. All Pharmacists Now Authorized to Administer Childhood Vaccines. Drug Topics. Published August 21, 2020. Accessed June 18, 2021.

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