Data from the National Immunization Survey-Child (NIS-Child) were analyzed to estimate coverage with childhood vaccines recommended by the Advisory Committee on Immunization Practices among U.S. children by age 24 months. Coverage with nearly all vaccines was lower among children born in 2020 and 2021 than it was among those born in 2018 and 2019, with declines ranging from 1.3 to 7.8 percentage points. Analyses of NIS-Child data for earlier birth cohorts have not revealed such widespread declines in routine childhood vaccination coverage. Coverage among children born during 2020-2021 varied by race and ethnicity, health insurance status, poverty status, urbanicity, and jurisdiction. Compared with non-Hispanic White children, coverage with four of the 17 vaccine measures was lower among non-Hispanic Black or African American children as well as Hispanic or Latino (Hispanic) and non-Hispanic American Indian or Alaska Native children. Coverage was also generally lower among those covered by Medicaid or other nonprivate insurance, uninsured children, children living below the federal poverty level, and children living in rural areas. Coverage varied widely by jurisdiction, especially coverage with ≥2 doses of influenza vaccine. Children born during 2020-2021 were born during or after the period of major disruption of primary care from the COVID-19 pandemic. Providers should review children's histories and recommend needed vaccinations during every clinical encounter. Addressing financial barriers, access issues, vaccine hesitancy, and vaccine-related misinformation can also help to increase coverage, reduce disparities, and protect all children from vaccine-preventable diseases. Strategies that have been found effective include implementation of standing orders and reminder and recall systems, strong physician recommendations to vaccinate, and use of immunization information systems to identify areas of lower coverage that could benefit from targeted interventions to increase immunization rates.

中文翻译：

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2020 年和 2021 年出生儿童按 24 个月年龄划分的疫苗接种覆盖率下降和疫苗接种不平等 - 全国免疫调查 - 美国儿童，2021-2023 年。


分析了来自全国免疫调查-儿童 （NIS-Child） 的数据，以估计免疫实践咨询委员会推荐的儿童疫苗在 24 个月大时在美国儿童中的覆盖率。2020 年和 2021 年出生的儿童几乎所有疫苗的覆盖率都低于 2018 年和 2019 年出生的儿童，下降幅度从 1.3 到 7.8 个百分点不等。对早期出生队列的 NIS-Child 数据的分析并未显示常规儿童疫苗接种覆盖率如此普遍的下降。2020-2021 年出生的儿童的覆盖范围因种族和民族、健康保险状况、贫困状况、城市化和司法管辖区而异。与非西班牙裔白人儿童相比，非西班牙裔黑人或非裔美国儿童以及西班牙裔或拉丁裔（西班牙裔）和非西班牙裔美国印第安人或阿拉斯加原住民儿童对 17 项疫苗措施中 4 项的覆盖率较低。医疗补助或其他非私人保险所覆盖的人、没有保险的儿童、生活在联邦贫困线以下的儿童以及生活在农村地区的儿童的覆盖率通常也较低。覆盖范围因司法管辖区而异，尤其是 ≥2 剂流感疫苗的覆盖率。2020-2021 年出生的儿童是在 COVID-19 大流行对初级保健造成重大破坏期间或之后出生的。提供者应审查儿童的病史，并在每次临床就诊时推荐所需的疫苗接种。解决财务障碍、获取问题、疫苗犹豫和与疫苗相关的错误信息也有助于扩大覆盖面、缩小差距并保护所有儿童免受疫苗可预防疾病的侵害。 已发现有效的策略包括实施常规命令以及提醒和召回系统、医生强烈建议接种疫苗，以及使用免疫信息系统来确定覆盖率较低的地区，这些地区可以从有针对性的干预措施中受益，以提高免疫接种率。