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Low-income kids less likely to get all childhood vaccines
The Commonwealth Fund said that 62.3% of low-income kids have gotten all early childhood vaccines compared to 77.9% of high-income kids who have.
Kids from low-income families are less likely to have received all seven shots in the early childhood vaccine schedule, according to a new analysis from the Commonwealth Fund, illustrating another example of preventive care disparities.
The report, which used data from the Commonwealth Fund's 2025 Scorecard on State Health System Performance, showed that only 62.3% of low-income kids living below 200% of the federal poverty level (FPL) had gotten the entire slate of early childhood vaccines. For middle-income kids, that number was 70.3%, while 77.9% of high-income kids had gotten the shots.
These findings come as the nation grapples with a multifaceted childhood vaccination problem. Since 2020, childhood vaccination rates have been subpar, driven in part by limited preventive care access caused by the pandemic. That limited access, plus trends of vaccine hesitancy, have been cause for concern among the nation's pediatricians.
This latest report, which looks at how many kids have gotten all seven of the key vaccines recommended during childhood, illustrates another issue: pediatric vaccine disparities.
This trend has been somewhat consistent, the Commonwealth Fund showed. The report provides information dating back to 2014, revealing that kids living below 200% FPL are less likely to have received all seven key childhood vaccines compared to their higher-income peers living at or above 300% FPL.
This trend largely persists when examining a state-by-state breakdown. In every state except for Connecticut, kids living at or above 300% FPL were more likely to have gotten all early childhood vaccines compared to those living below 200% FPL.
In a few states -- New Mexico, Kansas, Idaho, Wisconsin, Texas and North Carolina -- middle-income kids living between 200 and 299% FPL were the most likely to have completed the early childhood vaccine schedule.
But, for the most part, vaccination rates were best among high-income children.
Vaccination rates among low-income kids ranged from 48.7% in Montana to 89.1% in Massachusetts, the data furthered. Rates among the highest-income kids ranged from 67% in Alaska to 90.5% in Massachusetts.
Low vaccination rates are driven by more than just costs
Importantly, it's not just costs that drive income-based disparities in childhood vaccination rates, the Commonwealth Fund experts stressed. Most private insurance plans cover recommended preventive care, such as childhood vaccines, eliminating the cost barrier for many families.
Moreover, the 1994 Vaccines for Children (VFC) program made it so certain eligible children -- such as kids without insurance, who are covered by Medicaid or who are American Indian/Alaska Native -- could get no-cost routine vaccinations. The VFC program has been widely adopted by pediatricians nationwide.
"While the VFC program reduces the financial barriers to vaccination among low-income children, cost is only one obstacle," the researchers explained. "Logistical challenges, including long travel times in rural areas, appointment scheduling issues, and caregiver challenges like difficulty taking time off from work, and transportation and childcare issues can lead to missed appointments."
Life changes like moving residences can also complicate matters. Limited health data interoperability may mean kids' vaccination records get lost in the shuffle and a new provider cannot adequately engage the family in preventive care.
The researchers urged key interventions such as better appointment reminder systems and better integration of vaccination records within EHRs.
"But growing vaccine hesitancy, driven by the COVID pandemic, the spread of vaccine-related misinformation, and declining public trust in health and science institutions, could hinder the efficacy of interventions," the researchers concluded. "Strategies for clinicians to communicate effectively and build trust with parents and caregivers about childhood vaccines are needed more than ever."
Sara Heath has reported news related to patient engagement and health equity since 2015.
