Thirty years since its inception, the US Vaccines for Children (VFC) program has tracked several successes but still has areas for improvement, according to a Vital Signs report published yesterday by the Centers for Disease Control and Prevention (CDC).
Since 1994, the VFC has provided childhood vaccines at no cost to eligible children, including American Indian or Alaska Native children, those insured by Medicaid or Indian Health Service (IHS), the uninsured, and kids who had received at least one vaccination at an IHS-operated center, Tribal health center, or urban Indian health care facility.
In the report, researchers analyzed data from the 2012-2022 National Immunization Survey-Child (NIS-Child) to assess trends in vaccination coverage with the measles, mumps, and rubella vaccine (MMR), rotavirus vaccine, and a combined seven-vaccine series, including all recommended doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, poliovirus vaccine, measles-containing vaccine, Haemophilus influenzae type b conjugate vaccine (Hib), hepatitis B vaccine, varicella vaccine, and pneumococcal conjugate vaccine (PCV).
The researchers looked at uptake by VFC program eligibility status and examined differences in coverage among VFC-eligible children by sociodemographic characteristics, the authors said.
Overall in 2021 and 2022, 52.2% of US children were VFC-eligible.
Uptake of multi-dose vaccines problematic
As reported last week in Morbidity and Mortality Weekly Report, in the past 30 years, US childhood vaccines have prevented an estimated 508 million cases of illness, 32 million hospitalizations, and 1.1 million deaths, resulting in direct savings of $540 billion and societal savings of $2.7 trillion.
But the report published today shows that only 61% of VFC-eligible children born in 2020 received the seven selected vaccine by their second birthday.
Vaccination coverage was lowest (74% to 77%) for vaccines that require multiple doses, with at least one dose recommended after 12 months of age (DTaP, PCV, and Hib). Among children born in 2020, coverage with more than one dose of MMR, rotavirus vaccine, and the combined seven-vaccine series was 3.8, 11.5, and 13.8 percentage points, respectively, lower among VFC-eligible than among non–VFC-eligible children.
"This suggests children face challenges to receiving vaccines that require multiple doses as well as doses in the second year of life," the CDC said in a statement.
This suggests children face challenges to receiving vaccines that require multiple doses as well as doses in the second year of life
Coverage overall was still high, however: Among VFC-eligible children born during 2011 to 2020, coverage by age 24 months with one or more MMR dose and the combined seven-vaccine series was stable (88.0% to 89.9% and 61.4% to 65.3%, respectively. This highlights VFC program efforts in achieving and maintaining measles elimination status in the United States, the CDC said.
Overall, uninsured children had lower vaccination rates than Medicaid-insured children. They were also less likely to have not seen a medical provider within the past year or complete a vaccine series requiring multiple doses.
"Routine vaccinations are our best defense against illnesses that can make kids seriously ill, a key tool that can keep kids healthy in school and ready to learn," said CDC Chief Medical Officer Deb Houry, MD, MPH, in a telebriefing. "This program serves as one of the nation’s most important contributors to health equity. It helps all children have a better chance of getting their recommended vaccinations on schedule."
