Impact of the COVID-19 Pandemic on National Pediatric Inpatient Vaccine Delivery

BACKGROUND AND OBJECTIVES Pediatric vaccine uptake declined during the COVID-19 pandemic; however, little is known about the pandemic’s effect on hospital-based immunization. We aim to describe the pandemic’s impact on national inpatient pediatric vaccine delivery rates for birth- and non-birth-dose hepatitis B vaccines (Hep B), Haemophilus influenzae type B vaccines (Hib), pneumococcal-containing vaccines (PCVs), tetanus toxoid-containing vaccines (TTCVs), and influenza vaccines (IIVs). METHODS In this retrospective multicenter study, the Cerner Real-World Data electronic health record database was used to determine pediatric inpatient vaccine delivery rates for the prepandemic (May 2017 to April 2020) and postpandemic (May 2020 to April 2023) periods. Time plots were constructed to view vaccine delivery longitudinally, and interrupted time series analysis evaluated variation in slope of vaccine delivery rates between the periods while controlling for demographic, patient-level, and health system characteristics. RESULTS A total of 5 478 192 patient encounters across 91 health systems were included. Average vaccination rates increased throughout the study period for all vaccine types; however, there was a significant decrease in monthly vaccine delivery rate slopes in the postpandemic period for IIVs (slope change, −0.108; 95% CI, −0.186 to −0.031) and birth-dose Hep B (slope change, −0.445; 95% CI, −0.651 to −0.239). There were no significant differences in slopes between the periods for non-birth-dose Hep B, Hib, PCV, or TTCV delivery rates. CONCLUSIONS Inpatient vaccine delivery generally increased over time; however, slopes of vaccine delivery decreased in the postpandemic period for IIVs and birth-dose Hep B. Further research is needed to understand these patterns and optimize hospital-based vaccine delivery.