Peer-reviewed article

Vaccination Coverage by Age 24 Months Among Children Born in 2021 and 2022 - National Immunization Survey-Child, United States, 2022-2024.

Holly A Hill, David Yankey, Laurie D Elam-Evans, Yi Mu, Michael Chen et al. · 26 Mar 2026

Abstract

The National Immunization Survey-Child monitors coverage with recommended routine childhood vaccines. For data collected in survey year 2024, which include children born in 2021 and 2022, the household response rate (23.4%) and availability of adequate provider data for children with completed interviews (51.4%) were comparable to those from earlier survey years. For most vaccines, coverage by age 24 months was similar among children born in 2021 and 2022 and those born in 2019 and 2020. Declines in coverage of 1-2 percentage points were observed for the primary series of Haemophilus influenzae type b conjugate vaccine, the birth dose of hepatitis B vaccine, ≥4 doses of pneumococcal conjugate vaccine, and rotavirus vaccine. Coverage with ≥2 doses of influenza vaccine by age 24 months decreased from 61.0% among children born during 2019-2020 to 53.5% among those born during 2021-2022. Coverage was lower among Vaccines for Children (VFC) program-eligible children than among those who were not VFC-eligible and differed substantially by jurisdiction. Compared with non-Hispanic White children, coverage with many vaccines was lower among non-Hispanic Black or African American and Hispanic or Latino children; coverage was highest among non-Hispanic Asian children. Coverage was also lower among children living in poverty and those living in more rural areas. Maintaining high levels of vaccination and improving coverage among groups and in areas in which rates have declined could help protect children from vaccine-preventable morbidity and mortality. The Community Preventive Services Task Force recommends several interventions to increase vaccination, including standing orders for vaccination, immunization information systems, and vaccination programs in organized child care centers and in Special Supplemental Nutrition Program for Woman, Infants, and Children settings. Other factors demonstrated to be effective include strong provider recommendations, targeted messages from credible and trusted sources, and increased participation in the VFC program.