Childhood Immunization Gaps in New York State After COVID-19: A Focus on Regional Disparities.

Introduction Vaccination is one of the most effective public health measures for preventing infectious diseases. However, the pandemic of the coronavirus disease 2019 (COVID-19) disrupted routine immunization services worldwide, raising concerns about reduced childhood vaccination coverage. New York State (NYS), particularly New York City (NYC), experienced significant pandemic-related challenges that may have impacted pediatric immunization rates. Materials and methods This study analyzed childhood vaccination coverage in NYS using the Centers for Disease Control and Prevention's data. It compared the vaccination coverage during the pre-pandemic period (2018-2019) to the post-pandemic period (2020-2021). Vaccination rates for nine recommended vaccines by 24 months of age were examined across three geographic categories: NYS overall, NYC, and the rest of NYS (excluding NYC). Statistical analyses included one-way analysis of variance with Tukey's post hoc test, with significance at a probability value (or p) less than 0.05. Results In NYS overall, vaccination rates declined slightly from 80.29% pre-pandemic to 78.97% post-pandemic (p = 0.6008). The rest of NYS (excluding NYC) showed a similarly modest decline (80.19% to 79.85%, p = 0.9985). In contrast, NYC experienced a significant reduction from 80.41% to 77.82% (p = 0.0288). Measles, mumps, and rubella (MMR) vaccination rates declined statewide, with coverage falling from 93.30% to 89.60% (p = 0.0459). In NYC, the decline was particularly pronounced, with MMR coverage dropping from 93.30% to 86.70% (p = 0.0039). Post-pandemic comparisons revealed significant disparities between NYC and the rest of NYS (p = 0.0128). Discussion The findings indicate that the pandemic disproportionately affected vaccination coverage in NYC, likely due to prolonged lockdowns, healthcare access barriers, and heightened vaccine hesitancy. While overall declines were modest, reductions in MMR coverage are particularly concerning given the resurgence of measles. The results underscore the importance of regionally tailored recovery strategies, including catch-up vaccination campaigns, improved healthcare delivery systems, and interventions to counteract misinformation. Conclusions The COVID-19 pandemic caused a measurable decline in childhood vaccination rates in NYS, with NYC experiencing the most significant reductions. Restoring vaccine coverage requires targeted interventions to strengthen healthcare resilience, rebuild public trust, and prevent future outbreaks of vaccine-preventable diseases.