Solving the Drop-off in Pediatric Immunization Rates

Improve Community Health One Child at a Time

CDC-recommended pediatric vaccinations include HepA and B, RV, DTaP, Hib, PCV, IPV, MMR, influenza, and varicella, among others.1 A drop-off in immunization rates occurs nationally during the toddler years, leaving many children vulnerable to preventable diseases.2 Toddlers failing to complete the pediatric vaccination series has been a challenge for years, long before the COVID-19 pandemic's impact on the industry.2 However, the pandemic has emphasized the importance of immunizations against vaccine-preventable diseases.

Consider these percentages of vaccinated children aged 19 to 35 months (2019)2:

Although DTaP and Hib incidence rates are low in the United States, these diseases have not disappeared, therefore, it is important to ensure patients complete their full vaccination series to help provide continuous protection.3 Now is the time to evaluate your practice to ensure every eligible child is up-to-date on their series.

aIncludes vaccinations received by age 24 months (before the day the child turns 24 months), except for ≥2 HepA doses by 35 months and Hib Primary series by 19 months. For all vaccines the Kaplan-Meier method was used to estimate vaccination coverage to account for children whose vaccination history was ascertained before age 24 months (35 months for ≥2 HepA doses, 19 months for and Hib Primary series).2

bIncludes children who might have been vaccinated with diphtheria and tetanus toxoids vaccine or diphtheria, tetanus toxoids, and pertussis vaccine.2

cHib primary series: receipt of ≥2 or ≥3 doses, depending on product type received; full series: primary series and booster dose, which includes receipt of ≥3 or ≥4 doses, depending on product type received.2

See Data Below on DTaP and Hib Vaccination Rates in Your State

DTaP Vaccination Coverage by Age 24 Months, 20202

DTaP 3+ Doses
National Estimate 93.7% Indicator
%
DTaP 4+ Doses
National Estimate 81.6% Indicator
 
%
 %
DTaP 3+ Doses to
4+ Doses Drop-offa

DTaP Drop-off Ratea Comparison by State2

%

Hib Vaccination Coverage by Age 24 Months, 20202

Hib Primaryb
National Estimate 92.3% Indicator
%
Hib Full
National Estimate 80.2% Indicator
 
%
 %
Hib Primary to
Hib Full Drop-offa

Hib Drop-off Ratea Comparison by State2

%

aDrop-off is the difference between 3rd to 4th DTaP dose and primary to full series of Hib for children aged 19 to 35 months (2020). In some cases confidence intervals may overlap at the state level resulting in data that may not be statistically significant.2

bIncludes vaccinations received by age 19 months for Hib Primary series by 19 months. The Kaplan-Meier method was used to estimate vaccination coverage to account for children whose vaccination history was ascertained before age 19 months for Hib Primary series.2

Historical DTaP Trends

While the global COVID-19 pandemic may be partially to blame for recent downward trends, DTaP series completion rates have historically fallen well below Healthy People 2030 goals.2,4

% Children With 4+ DTaP Doses Before Age 24 Months

X-axis is year ChildVax survey was fielded, among respondents age 24 months or greater at time of survey2,4

aData from January-December 2020.2,4

bData from February-October 2020.2,4

DTaP Claims, 2019 vs 20215,a

DTaP claims have struggled to recover from pre-pandemic figures.

# of DTaP Commercial Claims by Month, Children Age 0-2 (Total US)

aReflects private insurance claims only.

References: 1. Child and Adolescent Immunization Schedule. Centers for Disease Control and Prevention; 2022. Updated February 17, 2022. Accessed June 22, 2022. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. 2. Vaccination Coverage among Young Children (0-35 Months). Centers for Disease Control and Prevention; 2021. Updated February 11, 2022. Accessed June 22, 2022. https://data.cdc.gov/Child-Vaccinations/Vaccination-Coverage-among-Young-Children-0-35-Mon/fhky-rtsk/data 3. Centers for Disease Control and Prevention. In: Hall E, Wodi AP, Hamborsky J, Morelli V, Schillie S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 14th ed. Washington, DC: Public Health Foundation; 2021. Accessed June 23, 2022. https://www.cdc.gov/vaccines/pubs/pinkbook/index.htm 4. Increase the coverage level of 4 doses of the DTaP vaccine in children by age 2 years—IID-06. U.S. Department of Health and Human Services. Accessed June 23, 2022. 5. Data on file, IQVIA claims.