The Impact of the COVID-19 Pandemic on Influenza Vaccination Coverage Among Young U.S. Children: A Socioeconomic Analysis

The COVID-19 pandemic disrupted healthcare delivery across the United States (U.S.), including childhood vaccine administration. This study analyzed data from the National Health Interview Survey (NHIS), a nationally representative survey of the U.S. population, assessing trends and predictors of influenza vaccination uptake among children ≤ 5 years before and amid the COVID-19 pandemic. Influenza vaccination coverage declined significantly, from 56% in 2019 to 46% in 2022 (<i>p</i> < 0.001). Age-specific declines were notable, with rates dropping among one-year-olds from 68% to 53%, two-year-olds from 63% to 49%, and infants from 31% to 24% (<i>p</i> < 0.001). Logistic regression revealed African American children had lower odds of vaccination compared to non-Hispanic White children (OR = 0.70, <i>p</i> < 0.001), while Asian children had higher odds (OR = 1.32, <i>p</i> = 0.018). Uninsured children were less likely to be vaccinated than insured children (OR = 0.71, <i>p</i> = 0.022). Regional analysis showed the Northeast had the highest vaccination rates (60% in 2019, 56% in 2022), while the South had the lowest (52% in 2019, 41% in 2022). These findings underscore the need for targeted strategies to address socioeconomic disparities and improve influenza vaccine uptake in young children in the U.S.