Disparities in First Dose COVID-19 Vaccination Coverage among Children 5–11 Years of Age, United States

Abstract

A lthough more common among adults, severe coronavirus disease (COVID-19) and hospitalization can occur in children. Among >8,300 hospitalized children 5-11 years of age, 1/3 required intensive care (1,2). Children can transmit severe acute respiratory syndrome coronavirus 2 to others, highlighting the need for pediatric COVID-19 vaccinations. On November 2, 2021, the US Centers for Disease Control and Prevention (CDC) recommended the use of the Pfizer-BioNTech COVID-19 vaccine (Pfizer Inc., https://www.pfizer.com) in children 5-11 years of age. We analyzed first-dose vaccination coverage among children 5-11 years of age and stratified coverage by age group, sex, race/ ethnicity, and jurisdiction. The StudyWe analyzed COVID-19 vaccine administration data among children 5-11 years of age in the United States during November 2-December 31, 2021. We collected data that were reported to CDC from jurisdictions, pharmacies, and federal entities through immunization information systems, the Vaccine Administration Management System, and direct data submission by January 21, 2022 (Appendix, https://wwwnc.cdc. gov/EID/article/28/5/22-0166.pdf). We calculated daily and cumulative total numbers of children receiving the first dose of Pfizer-BioNTech COVID-19 vaccine. We calculated vaccination coverage by dividing the number of children who received the first vaccine dose by the total population of children in the corresponding age group living in the defined jurisdiction. We stratified vaccine coverage by jurisdiction, age group (5-6, 7-8, and 9-11 years), and sex. We obtained the population size for children 5-11 years of age from the US Census Bureau 2020 Population Estimates (3). Among 82.1% of children 5-11 years of age for whom race and ethnicity data were available, we calculated the percentage of children receiving their first COVID-19 vaccine dose by race/ ethnicity and compared this with the racial and ethnic makeup of the US population 5-11 years of age.We did not conduct tests for statistical significance because these data reflect US population and not population samples. We used SAS version 9.4 (SAS Institute, Inc., https://www.sas.com) to perform analyses. This study was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.

Factors Associated with Receipt and Parental Intent for COVID-19 Vaccination of Children Ages 5–11 years

“…The higher COVID-19 vaccination coverage among Asian non-Hispanic children is consistent with other studies and with what has been found for influenza vaccination. 6,20…”

“…The NIS-CCM survey weights adjust for non-response and households without cellular telephones and were calibrated to match counts of children with one or more doses of COVID-19 vaccine by sex within each U.S. Department of Health and Human Services (HHS) region for children ages 5–11 years as of mid-month, using data reported to CDC by jurisdictions. 6 T-tests for proportions were used to test for statistically significant differences with p <0.05. The NCHS reliability criteria for proportions was implemented and proportions not meeting the criteria were suppressed from the tables.…”

“…Department of Health and Human Services (HHS) region for children ages 5-11 years as of midmonth, using data reported to CDC by jurisdictions. 6 T-tests for proportions were used to test for statistically significant differences with p<0.05. The NCHS reliability criteria for proportions was implemented and proportions not meeting the criteria were suppressed from the tables.…”

“…3 Children might play an important role in the transmission of COVID-19, highlighting the importance of child vaccinations in the effort to reduce COVID-19 community transmission and hospitalization rates. 4 The U.S. Food and Drug Administration authorized the emergency use of the Pfizer-BioNTech COVID-19 vaccine for children ages [5][6][7][8][9][10][11] years in the United States on October 29, 2021, which was endorsed on November 2, 2021, by the Centers for Disease Control and Prevention (CDC) based on recommendations from the Advisory Committee on Immunization Practices. 5 Administrative data reported to CDC showed that coverage among children 5-11 years was 24% during the first two months of vaccine rollout, which was lower than coverage among those ages 12-15 years (33%) during the first two months of eligibility for that age group.…”

“…5 Administrative data reported to CDC showed that coverage among children 5-11 years was 24% during the first two months of vaccine rollout, which was lower than coverage among those ages 12-15 years (33%) during the first two months of eligibility for that age group. 6 A report on the safety of the Pfizer-BioNTech COVID-19 vaccine, the only COVID-19 vaccine authorized for 5-17 year olds, after administration of approximately 8 million doses to children ages 5-11 years found the vaccine to be safe, with mild to moderate local and systemic reactions to be expected after vaccination. 7 In two studies completed within 3-4 months of vaccine authorization, COVID-19 vaccine effectiveness after two doses among children ages 5-11 years was 31% against asymptomatic and symptomatic Omicron infection and 46% against COVID-19 associated emergency department and urgent care encounters.…”