Sociodemographic Risk Factors for Incomplete Routine Childhood Immunizations Among Children Born During the COVID-19 Pandemic,Louisiana,March 1,2020–July 1,2021

Abstract

Objective:

Routine childhood vaccination rates declined nationwide among children born during 2020-2021 compared with prior birth cohorts. We identified sociodemographic risk factors associated with incomplete 7-vaccine series among children born during widespread health care disruptions due to the COVID-19 pandemic.

Methods:

We retrieved childhood vaccination data from Louisiana’s Immunization Information System for children born from March 1, 2020, through July 1, 2021, to identify completion status of the 7-vaccine series by age 24 months. After geocoding home addresses, we used regression analyses and machine-learning models to identify social vulnerability factors at the individual and census-tract levels that were associated with 1 or more missing vaccine doses.

Results:

Children residing a greater distance from the vaccinating facility (adjusted odds ratio [AOR] = 1.12; 95% CI, 1.05-1.19; P = .002) and in a census tract with a larger low-income population than the statewide median (AOR = 1.14; 95% CI, 1.05-1.23; P = .006) had significantly higher odds of being 1 dose short of 7-vaccine series completion by age 24 months. Similarly, children residing in areas with a larger low-income (AOR = 1.18. 95% CI, 1.14-1.23; P < .001) and non-White (AOR = 1.07; 95% CI, 1.02-1.11; P = .04) population than the statewide median had higher odds of missing multiple doses of the 7-vaccine series by age 24 months.

Conclusion:

We need further research to identify and implement best practices that help socially vulnerable communities retain access to routine health care, such as childhood immunizations, during future public health emergencies.