2024 Scholars' Research Symposium Abstract: Effect of COVID-19 Pandemic on Routine Pediatric Vaccination Rates in 7 Upper Midwestern States.

INTRODUCTION: The COVID-19 pandemic stressed healthcare systems by increasing patient loads and creating shortages of both staffing and medical supplies. As a result, the process of administering routine pediatric vaccinations was affected. Multiple studies have reported ongoing decreases in vaccination opportunities. Completed vaccinations on the vaccination schedule for the pediatric population is a highly effective public health intervention and therefore should be maintained at high rates. Decreases in routine pediatric vaccinations could lead to the spread of multiple infectious diseases. The aim of this study is to assess the impact the COVID-19 pandemic had on routine pediatric vaccination rates in South Dakota and surrounding states. METHODS: ChildVaxView, a publicly available and de-identified dataset, was utilized in this research. The initial focus of this study was the vaccination rates for the state of South Dakota. To give context for vaccination rates for this state, responses of participants from South Dakota as well as those from the surrounding states of Iowa, North Dakota, Nebraska, Minnesota, Montana, and Wyoming from 2012-2022 were utilized for this project. The data was divided into 2 cohorts: "pre-pandemic vaccination" and "intra-pandemic vaccination". The rates of 5 different vaccinations from these 7 states were analyzed. The basic analysis method was an independent samples test of proportions which compared the "pre-pandemic" and "intra-pandemic" vaccination rates. P-values ≤ 0.05 were considered statistically significant. RESULTS: Responses compared the vaccination rates of the "pre-pandemic" period to the "intra-pandemic" period for all 7-states examined. OR values and 95% CI values are shown, where values less than 1 indicate higher "intra-pandemic" rates. In terms of 24-month PCV rates, Iowa (OR=0.76, 95%CI:0.60-0.97), Montana (OR=0.75, 95%CI:0.61-0.93), Nebraska (OR=0.77, 95%CI:0.61-0.99), and North Dakota (OR=0.77,95%CI:0.61-0.96) had higher "intra-pandemic" rates; Wyoming, South Dakota, and Minnesota showed no difference. For the 24-month polio vaccine, Montana had significantly higher "intra-pandemic" rates (OR=0.73,95%CI:0.54-0.98); the remaining states showed no difference. For the 24-month DTaP vaccine, North Dakota (OR=0.84, 95%CI:0.72-0.98), MT (OR=0.84, 95%CI:0.72-0.97), and Wyoming (OR=0.84, 95%CI:0.73-0.97) had significantly higher "intra-pandemic" vaccination rates, with no difference for the other states. The 6 surrounding states did not differ from South Dakota in polio vaccination rates "pre-pandemic" (p=0.54) nor "intra-pandemic" (p=0.36); there was additionally no difference between those states and South Dakota in the "pre-" vs "intra-pandemic" comparison (p=0.27). Similar results were seen for other vaccines. CONCLUSIONS: In this study, rates of a substantial proportion of pediatric vaccinations increased in the states of South Dakota, Iowa, Nebraska, North Dakota, Minnesota, Montana, and Wyoming since the onset of the COVID-19 pandemic. Several reasons for this surprising outcome were considered including amendments made to the Public Readiness and Emergency Preparedness (PREP) Act, reimbursement for clinics providing vaccinations under the Vaccination for Children (VFC) program, and increasing public awareness of the safety and efficacy of routine pediatric vaccinations.