Presentation (CTI)

OBJECTIVES: Distrust of vaccination has been increasing globally. Despite its established safety, efficacy, and critical role in public health, the measles/mumps/rubella (MMR) vaccine, is commonly targeted by anti-vaccination advocates. To assess how MMR coverage extends to other childhood vaccinations, this study examined coverage of 7 other vaccines in children with or without a MMR dose prior to 24 months of age.
METHODS: Children with continuous medical and pharmacy benefits from birth through 24 months were identified in the Merative^TM MarketScan^® Commercial Database. Cohorts of children who did or did not receive ≥1 dose of MMR in the first 24 months of life were defined; uptake of diphtheria/tetanus/pertussis (DTaP), pneumococcal conjugate (PCV-13), polio, rotavirus, haemophilus influenzae type b (Hib), varicella, and hepatitis A (HepA) were evaluated within the MMR and no MMR cohorts. Among vaccinated children, the number of vaccines, doses, and administration timing was also assessed.
RESULTS: A total of 287,223 children qualified for the analyses; 258,522 (90.0%) received the MMR vaccine, with 89.2% vaccinated per recommendation at 12-15 months of age. Nearly all children in the MMR cohort (>99.9%) received ≥1 dose for another vaccine of interest; 91.7% received ≥1 dose of all 7 vaccines. Within the no MMR cohort, 60.3% of children received ≥1 dose for another vaccine; 5.6% of children had ≥1 dose for all 7 other vaccines. Individual vaccination rates in the no MMR cohort ranged from 10.0% for varicella to 52.7% for DTaP. Children in the no MMR cohort who were vaccinated were also significantly less likely to be vaccinated on time compared to the MMR cohort.
CONCLUSIONS: Although lack of MMR was associated with fewer childhood vaccinations, many children without MMR received other vaccines; 40% received ≥5 vaccines. Results suggest that anti-vaccine tendencies are not absolute; further research is needed to help improve timely vaccination in the US.