The NCSL Blog


By Noah Cruz

As the world waits anxiously for a COVID-19 vaccine, the number of children receiving routine, non-flu immunizations has fallen significantly in many states. The pandemic has led many people to defer routine care including routine vaccinations.

Credit: American Association of PediatricsVaccination rates for Medicaid beneficiaries under age 2 were nearly 22% lower between March and May than the same period last year, according to the Centers for Medicare and Medicaid Services (CMS). Michigan, for example, reported an over 20% decrease in the rate of non-flu routine vaccines administered to children 18 years and younger since the state’s stay-at-home order was implemented on March 23.

Medicaid and the Children’s Health Insurance Program (CHIP) cover nearly 40 million children nationwide, including three quarters of children living in poverty. This group is using health services significantly less since the pandemic began.

Between March and May, the number of health screenings fell 44%, dental services 69% and mental health services 44%. Additionally, Medicaid-enrolled children experienced a steep drop in vaccination rates.

The Vaccines for Children (VFC) program, which provides federally purchased vaccines to approximately 50% of children from birth to 18 years of age, reports a substantial decrease in orders of measles and non-flu vaccines since the declaration of a national emergency on March 13.

Provider orders of routine childhood vaccines have dropped by over 10 million doses in 2020 compared to 2019, and though orders have started to rebound, they remain low going into 2021.

These low rates pose a significant public health risk amid an already unprecedented public health crisis. Schools struggling with mitigating the spread of COVID-19 as students return to the classroom may also need to beware of potential measles outbreaks, for example, like those seen in Washington state in 2019. Hospitals dealing with capacity issues due to COVID-19 may have difficulty providing safe and appropriate care if there is an outbreak of a vaccine-preventable disease among children.

States are taking action to ensure children have access to the vaccinations they need to stay healthy. To expand access, West Virginia enacted SB 544 that authorizes pharmacists and pharmacy interns to administer the Centers for Disease Control and Prevention’s (CDC) recommended immunization schedule for children and adolescents.

State legislatures have also acted to change immunization requirements for entry into schools. For example, Colorado passed SB 163 which created a standardized form and submission process for nonmedical vaccination exemptions and requires schools publish immunization and exemption data in hopes of reaching an immunization goal of 95% of the student population.

Experts emphasize the important role vaccines play in maintaining public health and recommend adherence to the childhood immunization schedule even as the country awaits a vaccine to counter COVID-19.

NCSL Resources

Noah Cruz is a research analyst in NCSL’s Health Program.

Email Noah.

This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $300,000 with 100% funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. government.

Posted in: Health, COVID-19
Actions: E-mail | Permalink |

Subscribe to the NCSL Blog

Click on the RSS feed at left to add the NCSL Blog to your favorite RSS reader. 

About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.