The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index; none of the 1 sources its claims cite is checked for support yet.
Decline in child vaccination coverage during the COVID-19 pandemic—Michigan Care Improvement Registry, May 2016–May 2020.
Open accessAbstract
On March 13, 2020, the United States declared a national state of emergency to control the pandemic spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1). Public health response measures to mitigate the pandemic have centered on social distancing and quarantine policies, including shelter-in-place and stay-at-home orders. Michigan implemented a stay-at-home order on March 23, 2020, to facilitate social distancing (2). Such strategies might result in decreased accessibility to routine immunization services, leaving children at risk for vaccine-preventable diseases and their complications (3). To evaluate whether vaccination coverage has changed during the pandemic, data from the Michigan Care Improvement Registry (the state's immunization information system) (MCIR) were analyzed. Changes in vaccine doses administered to children and the effects of those changes on up-to-date status were examined for vaccinations recommended at milestone ages corresponding to the end of an Advisory Committee on Immunization Practices (ACIP) recommendation period for one or more vaccines (4).
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
Using Michigan’s immunization information system, this report found declines in child vaccination coverage across most milestone age cohorts during the COVID-19 pandemic, with a notable drop at age 5 months and fewer noninfluenza vaccine doses administered in early 2020. Coverage was lower among Medicaid-enrolled children than among children not enrolled in Medicaid.
Key findings
- Vaccination coverage declined in all milestone age cohorts except birth-dose hepatitis B coverage, which is typically administered in the hospital setting.
- Among children aged 5 months, up-to-date status for all recommended vaccines fell from approximately two thirds during 2016–2019 (66.6%, 67.4%, 67.3%, and 67.9%, respectively) to 49.7% in May 2020.
- In the 16-month cohort, measles-containing vaccination coverage decreased from 76.1% in May 2019 to 70.9% in May 2020.
- Noninfluenza vaccine doses administered and reported to MCIR decreased 21.5% for children aged ≤18 years and 15.5% for children aged ≤24 months during January–April 2020 compared with averages for the same periods in 2018 and 2019.
- In May 2020, up-to-date series coverage was lower for Medicaid-enrolled children than for children not enrolled in Medicaid; the largest difference was at age 7 months, where 34.6% of Medicaid-enrolled children were up-to-date versus 55.0% of children not enrolled in Medicaid.
Methods
- The study analyzed data from the Michigan Care Improvement Registry (MCIR), Michigan’s immunization information system.
- Vaccination status was assessed for milestone age cohorts of children at ages 1, 3, 5, 7, 16, 19, and 24 months, with an average sample size of 9,269 for 2016–2019 and 9,539 for 2020.
- Up-to-date status was assessed at a point in time in May 2020 and compared with 1-month age cohort assessments in May 2016–May 2019; noninfluenza vaccine doses administered and reported to MCIR for children aged ≤18 years and ≤24 months were examined during January–April 2020 compared with averages for the same period in 2018 and 2019.
Limitations
- The paper does not include an explicit limitations section.
- Evident from the design: this is an observational analysis using a single state’s immunization registry, with point-in-time comparisons and no causal inference.
- Evident from the design: the analysis compares May 2020 with prior May assessments and January–April 2020 with 2018–2019 averages, without adjustment for potential confounders.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
7 Own result · 1 Not checked yet
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the number of noninfluenza vaccine doses administered and reported for children aged ≤18 years decreased 21.5%, and the number of doses administered to children aged ≤24 months decreased 15.5% during January-April 2020, compared with the same averaged periods in 2018 and 2019.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Up-to-date series coverage for each age cohort (1, 3, 5, 7, 16, 19, and 24 months) assessed in May 2020 was lower for Medicaid-enrolled children than for those children not enrolled in Medicaid.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Vaccination coverage declined in all milestone age cohorts, except for birth-dose hepatitis B coverage, which is typically administered in the hospital setting (Figure ).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among children aged 5 months, up-to-date status for all recommended vaccines declined from approximately two thirds of children during 2016-2019 (66.6%, 67.4%, 67.3%, 67.9%, respectively) to fewer than half (49.7%) in May 2020.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For the 16-month age cohort, coverage with all recommended vaccines declined, with measles-containing vaccination coverage decreasing from 76.1% in May 2019 to 70.9% in May 2020.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the number of noninfluenza vaccine doses administered and reported for children aged ≤18 years decreased 21.5%, and the number of doses administered to children aged ≤24 months decreased 15.5% during January-April 2020, compared with the same averaged periods in 2018 and 2019.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 2
- Probably not a substantial claim. 1
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The largest difference was in the age 7 months cohort assessed in May 2020; in that cohort, 34.6% of Medicaidenrolled children were up-to-date for their recommended series, compared with 55.0% of children not enrolled in Medicaid.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Such strategies might result in decreased accessibility to routine immunization services, leaving children at risk for vaccine-preventable diseases and their complications (3).”
What the sources say
- Not checked yetcites [3] Santoli, 2020, Effects of the COVID-19 pandemic on routine pediatric vaccine ordering and administration—United States, 2020, MMWR Morb Mortal Wkly Rep source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
The paper relies on this without support.
Measles vaccination coverage of 90%-95% is the level needed to establish herd immunity.
“If measles vaccination coverage of 90%-95% (the level needed to establish herd immunity) is not achieved, measles outbreaks can occur.”
The paper relies on this without support.
Measles outbreaks can occur when measles vaccination coverage falls below 90%-95%.
“If measles vaccination coverage of 90%-95% (the level needed to establish herd immunity) is not achieved, measles outbreaks can occur.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“After the March 2020 declaration of the COVID-19 pandemic in the United States, an analysis of provider ordering data from the federally funded Vaccines for Children program found a substantial decrease in routine pediatric vaccine ordering (1), and data from New York City and Michigan indicated sharp declines in routine childhood vaccine administration in these areas (2,3).”
Citations
Cites
American Academy of Family Physicians
(1966) · New England Journal of Medicine · doi:10.1056/nejm196611172752014 · Cited by 1,947
Santoli, J. M., Lindley, M. C., DeSilva, M. B., Kharbanda, E. O., Daley, M. F., Galloway, L., Gee, J., Glover, M., Herring, B., Kang, Y., et al. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6919e2 · Cited by 701
Cited by
Sorted by citations
Alexander, G. C., Tajanlangit, M., Heyward, J., Mansour, O., Qato, D. M., & Stafford, R. S. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.21476 · Cited by 461
Antimicrobial resistance and COVID-19: Intersections and implications
Knight, G. M., Glover, R. E., McQuaid, C. F., Olaru, I. D., Gallandat, K., Leclerc, Q. J., Fuller, N. M., Willcocks, S., Hasan, R., van Kleef, E., et al. (2021) · eLife · doi:10.7554/elife.64139 · Cited by 372
Vaccines and routine immunization strategies during the COVID-19 pandemic
Dinleyici, E. Ç., Borrow, R., Sáfadi, M. A. P., Damme, P. V., & Muñoz, F. M. (2020) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2020.1804776 · Cited by 306
The impact of the COVID-19 pandemic on immunization campaigns and programs: a systematic review
Lassi, Z. S., Naseem, R., Salam, R. A., Siddiqui, F., & Das, J. K. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18030988 · Cited by 251
“observed a decline in all milestone age cohorts, except for birthdose hepatitis B coverage which is customarily administered in hospitals [30].”
BackgroundResultInfluentialPatel Murthy, B., Zell, E., Kirtland, K., Jones-Jack, N., Harris, L., Sprague, C., Schultz, J., Le, Q., Bramer, C. A., Kuramoto, S., et al. (2021) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7023a2 · Cited by 192
Self-citation
Metadata
- Authors
- Bramer, C. A., Kimmins, L. M., Swanson, R., Kuo, J., Vranesich, P., Jacques-Carroll, L. A., & Shen, A. K.
- Corresponding author
- Bramer, Cristi A.
- ORCID
- Shen, Angela K.
- Venue
- MMWR. Morbidity and Mortality Weekly Report
- Published
- 2020-05-22
- Volume
- 69
- Issue
- 20
- Pages
- 630-631
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- OpenAlex
- W3024637813
- Semantic Scholar
- ee9b1379e7e406be53e9ecc26d29d2ad5303301c
- Cited by
- 297
- References
- 2
- Citations by year
- 2026: 5 · 2025: 17 · 2024: 26 · 2023: 43 · 2022: 46 · 2021: 109 · 2020: 51
- FWCI
- 34.42
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- childhood vaccination coverage, COVID-19 pandemic, vaccine-preventable diseases, stay-at-home orders, social distancing, immunization information systems, Michigan
- MeSH terms
- Vaccination Coverage, COVID-19, Child, Preschool, Humans, Infant, Michigan, Pneumonia, Viral, Registries, Coronavirus Infections, Pandemics, Quality Improvement
About these checks
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