EHRN: Non-COVID Vaccination Numbers Are Lagging for Teens, Rebounding for Younger Kids

EHRN: Non-COVID Vaccination Numbers Are Lagging for Teens, Rebounding for Younger Kids

Abstract: Pediatric vaccination rates increased in 2021, though they remain slightly below pre-pandemic levels.

Team A: Steve Allen, MD | Xander Posner, MPH
Team B: Brad Fox, MD | Neil Sandberg | Justin Lo, PhD, MT(ASCP)
9 Sep 2021

A previous EHRN study showed that immunizations for pediatric patients decreased by 42% in the spring of 2020.1 We completed a follow-up study of 6,525,735 pediatric patients to assess whether pandemic-era immunization rates for CDC-recommended immunizations2 have returned to historical rates. As shown in Figure 1, younger age groups have largely returned to predicted levels, while older groups have remained below expected levels.

Weekly Immunization Administrations During COVID-19

Figure 1. Weekly immunization administrations during the COVID-19 pandemic compared to prior years, split into patient age group.

For school-age children, immunization volume typically spikes from mid-July through August as patients get immunizations required for the school year. In 2020, this increase was smaller than in pre-pandemic years, especially for older patients.

In 2021, pediatric vaccination rates have improved from their pandemic lows. Patients 6 years old and younger received almost all the expected immunizations, patients 7-12 years old received fewer immunizations than expected, and patients 13-18 years old continued to show the largest gap between expected and received immunizations.


These data come from Cosmos, a HIPAA-Limited Data Set of more than 118 million patients from 136 Epic organizations including 705 hospitals and 12,172 clinics, serving patients in all 50 states. This study was completed by two teams, composed of clinicians and data scientists, that independently acquired and analyzed data. Both teams were involved in the interpretation of results and drafting of this brief. Overall, the two teams came to similar conclusions.