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

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.