604 - Comparison of Routine Vaccination Rates in the First 6 Months of Life Before and During the COVID Pandemic

Poster Number: 604
Publication Number: 604.209

Veeraya K. Tanawattanacharoen, Harvard Medical School, Boston, MA, United States; Snehal N. Shah, Boston Children's Hospital, Boston, MA, United States; Kathleen N. Conroy, Boston Children's Hospital, Boston, MA, United States

Background: Infant vaccination rates decreased nationally during the COVID-19 pandemic.  Changes in health care delivery - office closures, transition to virtual care, or adherence to quarantine guidelines - may have contributed to this decline.  The American Academy of Pediatrics advocated for preservation of infant well care, and some systems opted to prioritize infant well care during the pandemic.

Objective: To understand the impact of the COVID-19 pandemic on infant vaccination rates when pandemic-related care adjustments included prioritization of infant care.  

Design/Methods: This is a retrospective cohort study in one academic primary care system serving a majority minority and medicaid insured population which made pandemic-related care adjustments including remaining open for in person infant well visits, separation of well and sick visit locations, counseling for families regarding new office procedures, and systems to reduce family barriers (ie, transportation) that may have increased because of the pandemic.  Demographic data and vaccination records were collected from the electronic health record. There were 1164 controls and 1072 subjects who received care from 0-6 months of age during and one year prior to the start of COVID shutdown in MA (March 13, 2020), respectively. Appropriate age ranges for DTaP, Hep B, Hib, IPV, PCV, and ROTA vaccination were determined by CDC guidelines. Comparative analysis was performed during a yearlong time period and during the time period of emergency shutdown locally (March 13-July 5 2020). Chi-squared tests compared controls and subjects on uptake of vaccines.

Results: The control and subject groups were comparable by sex (controls 46%, subjects 47% female, p = 0.5), race/ethnicity (controls 52%, subjects 51% latino, p = 0.8), and interpreter needs (p = 0.5). Significant differences in rates of vaccination were found at 2 months, with the yearlong analysis showing controls having higher rates of DTaP, Hib, and ROTA and shutdown analysis showing controls having higher rates of DTaP, Hib, and PCV as compared to subjects (see table). The birth, 1 month, 4 month, and 6 month time points were statistically comparable between groups at both time periods, but during the shutdown period rates were almost all lower among subjects compared to controls.
 Conclusion(s): In a system that attempted to reduce health-care and family barriers to infant vaccination, rates of infant vaccination during the COVID-19 pandemic were largely comparable to non-pandemic rates overall, even during the emergency shutdown, suggesting that COVID-induced barriers to routine care can be overcome.  
VKT Curriculum VitaeCV_PAS Meeting.pdf