Explainable Machine Learning for Public Health Informatics in HEDIS Childhood Immunization Status Combination 10.

Completion of the HEDIS (Healthcare Effectiveness Data and Information Set) Childhood Immunization Status Combination 10 (Combo 10) measure among US children aged 24-35 months declined from 53.7% in 2021 to 44.6% in 2023, with a statistically significant survey-weighted annual trend. An explainable machine learning approach identified influenza vaccination and rotavirus series completion as the strongest component-level drivers of Combo 10 completion, supporting targeted public health quality improvement.