384 - Childhood Vaccination and Influenza Vaccination Rates Before and After the COVID-19 Pandemic: A Comparative Analysis in a Community Hospital-Based General Pediatrics Clinic

Publication Number: 2373.384

Handenur ILGUN, Henry Ford St John Children's Hospital, Harper Woods, MI, United States; Justino Zoma, Henry Ford Health, Detroit, MI, United States

Background: Routine childhood and influenza vaccinations are essential for preventing morbidity and mortality from vaccine-preventable diseases.The COVID-19 pandemic, declared by the WHO in March 2020, however, disrupted immunization efforts, leading to a decline in routine childhood and influenza vaccination rates.Understanding post-pandemic vaccination trends and identifying factors associated with vaccine uptake is crucial for informing public health strategies.This study aims to assess changes in routine childhood and influenza vaccination rates before and after the pandemic.

Objective: This study aims to (1) compare routine childhood and influenza vaccination rates before and after the pandemic, and (2) identify risk factors associated with vaccination status in a community hospital-based general pediatrics clinic (CHGPC).

Design/Methods: This was a cross-sectional study of vaccine uptake among patients seen at a CHGPC.A random sample of 500 patients from the pre-COVID (6/1/2018-5/31/2019) and 500 patients from the post-COVID (6/1/2023-5/31/2024) period was selected from regular clinic patients.Data were collected by review of the electronic medical record on vaccination status and demographic factors.The Michigan Care Improvement Registry was used to verify vaccine status.Data were analyzed using Student's t-test and chi-squared analysis.A p-value less than 0.05 was taken to indicate statistical significance.Data were analyzed using SPSS v. 31.0.

Results: Most of the patients were non-Hispanic Black (88%) and had Medicaid (89%).The mean ages for the pre- (2018-19) and post-Covid (2023-24) periods were 5.1 and 4.8 ± 3.7 years, respectively.All patients in the selected group were eligible to receive the influenza vaccine.In the 2018-19 flu season, 32.9% received the vaccine, compared to 17.8% in the 2023-24 season (p < 0.001).Among all pre- and post-COVID patients, Non-Hispanic Black patients had the second lowest rate of influenza vaccination (24.4%), after those who declined to share their race, (14.3%) (p < 0.05).No other significant differences were found by age, race, sex, and insurance for influenza vaccination.For each childhood immunization (DTaP, Polio, HepB, MMR, Varicella, HiB, and PPV), rates declined in the post-COVID period, but statistically significant decrease was found only for HiB (p < 0.05).

Conclusion(s): Given prior reports of declining vaccination rates for both childhood and influenza vaccines during the pandemic, this study demonstrated that these rates continued to decrease after the COVID-19 pandemic in a CHGPC.The influenza vaccination rate has declined even more markedly after the pandemic.

Immunization Rates: Pre- vs. Post-COVID
For each type of immunization, rates declined in the post-COVID period; however, statistically significant decreases were found for only HiB (p < 0.05) and influenza (p < 0.001) vaccines.

Influenza vaccination
influenza_vaccine_table_grayscale_updated.jpegDuring the post-COVID period, the percentage of patients who did not receive the influenza vaccine significantly increased from 62% to 82.2% (p < 0.001). Among these patients, refusal due to parental decision was higher in the post-COVID period, rising from 14.6% to 27.6%. These findings indicate that influenza vaccine hesitancy increased markedly in our patient population following the pandemic.