Written by Hannah Harp
Spoon Feed
In this U.S. study, 15% of children under the age of 3 were found to have received at least one invalid dose, with only 45% receiving the appropriate extra dose.
Hit me with your best shot!
Invalid vaccinations given outside of the recommended age and interval ranges increase risk of vaccine-preventable diseases. Fragmented health information systems, state-based vaccine databases, and lack of an established PCP can contribute to invalid vaccine administration. The study assessed the prevalence and factors associated with invalid vaccine doses among U.S. children aged 0–35 months. Using data from the 2011–2020 National Immunization Survey-Child, 15.4% (95%CI 15.0–15.8%) of 161,187 children received at least one invalid dose. The most common errors involved rotavirus (4.4%), Haemophilus influenzae type b (3.3%), and hepatitis A (2.3%) vaccines. Lowest rates of vaccine series completion following the invalid dose were seen with Hep A (11.7%, CI 9.3-14) and Hep B (13.6%, CI 11.1-16.2). Children with >3 providers and children moving across state lines had higher odds of receiving invalid doses (aOR 1.5, 95%CI 1.2-1.8, 1.4-1.6). Because the data is survey-based, the study adjusted for non-response bias, but may miss vaccine doses if incomplete records were submitted and cannot account for incorrect documentation.
How will this change my practice?
This certainly resonates. As a pediatrician at a clinic with a large immigrant population, I do a lot of vaccine catch-ups, and I know there is a lot of room for error. Add in flexible administration schedules (Hib, PCV, HBV, and IPV), brands of vaccines with different number of primary doses (Hib, rotavirus), inaccurate EMR vaccine reminders, and parents requesting alternative schedules – and it’s easy to see why so many mistakes are made.
Source
Invalid Vaccine Doses Among Children Aged 0 to 35 Months: 2011 to 2020. Pediatrics. 2025 Feb 1;155(2):e2024068341. doi: 10.1542/peds.2024-068341. PMID: 39788151
