Teasdale Chloe A, Borrell Luisa N, Shen Yanhan, Kimball Spencer, Zimba Rebecca, Kulkarni Sarah, Rane Madhura, Rinke Michael L, Fleary Sasha A, Nash Denis
Department of Epidemiology and Biostatistics, City University of New York (CUNY) Graduate School of Public Health and Health Policy (SPH), New York, NY, USA; Institute for Implementation Science in Population Health, CUNY, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Department of Epidemiology and Biostatistics, City University of New York (CUNY) Graduate School of Public Health and Health Policy (SPH), New York, NY, USA.
Prev Med. 2022 May;158:107025. doi: 10.1016/j.ypmed.2022.107025. Epub 2022 Mar 19.
The COVID-19 pandemic has decreased uptake of pediatric preventive care, including immunizations. We estimate the prevalence of missed pediatric routine medical visits and vaccinations over the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey of 2074 US parents of children ≤12 years in March 2021 to measure the proportion of children who missed pediatric care and vaccinations over the first 12 months of the COVID-19 pandemic. Poisson regression models were fitted to estimate adjusted prevalence ratios (aPR). All analyses were weighted to represent the target population. Overall, 41.3% (95%CI 38.3-43.8) of parents reported their youngest child missed a routine medical visit due to the COVID-19 pandemic. Missed care was more common among children ≥2 years compared to <2 years (aPR 1.82; 95%CI 1.47-2.26) and Hispanics compared to non-Hispanic Whites (aPR 1.31; 95%CI 1.14-1.51). A third of parents (33.1%; 95%CI 30.7-35.5) reported their child had missed a vaccination. Compared to the 2019-20 flu season, pediatric influenza vaccination decreased in 2020-21 (51.3% vs. 62.2%; p < 0.0001). A high proportion of US children ≤12 years missed routine pediatric care during the COVID-19 pandemic. Catch-up efforts are needed to ensure continuity of preventive care for all children.
新冠疫情导致儿童预防性保健服务的利用率下降，包括免疫接种。我们估算了新冠疫情第一年中儿童错过常规医疗就诊和疫苗接种的比例。2021年3月，我们对2074名美国12岁及以下儿童的家长开展了一项横断面在线调查，以衡量在新冠疫情的头12个月里错过儿童保健和疫苗接种的儿童比例。采用泊松回归模型来估算调整患病率比（aPR）。所有分析均进行加权以代表目标人群。总体而言，41.3%（95%置信区间38.3 - 43.8）的家长报告其最小的孩子因新冠疫情错过了常规医疗就诊。与2岁以下儿童相比，2岁及以上儿童错过保健服务的情况更为常见（aPR 1.82；95%置信区间1.47 - 2.26）；与非西班牙裔白人相比，西班牙裔儿童错过保健服务的情况更为常见（aPR 1.31；95%置信区间1.14 - 1.51）。三分之一的家长（33.1%；95%置信区间30.7 - 35.5）报告其孩子错过过疫苗接种。与2019 - 20流感季相比，2020 - 21年儿童流感疫苗接种率有所下降（51.3%对62.2%；p < 0.0001）。在新冠疫情期间，美国很大比例的12岁及以下儿童错过了常规儿童保健服务。需要开展补种工作以确保所有儿童的预防性保健服务的连续性。
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