COVID-19 pandemic-related disruptions contributed to many children missing well-child visits and recommended childhood and adolescent vaccinations (Kujawski et al., 2022; DeSilva et al., 2022; Seither et al., 2022). During March-April 2020, a substantial decline in Vaccines for Children (VFC)-funded vaccine ordering was observed (Santoli et al., 2020). A subsequent analysis of childhood and adolescent vaccine administration in 10 U.S. jurisdictions revealed that, following an initial dip during March-May, a partial recovery occurred during June-September 2020 (Santoli et al., 2020; Patel Murthy et al., 2021). The most recent National Immunization Survey-Child (NIS-Child) data, collected during 2019-2021, showed no overall decline in estimated routine vaccination coverage associated with the COVID-19 pandemic among children born during 2018-2019, many of whom had vaccine doses recommended after the pandemic was declared (Hill et al., 2023). However, the 2022 NIS-Teen survey data showed that vaccination coverage by age 14 years among adolescents born in 2008 continued to lag that of earlier birth cohorts and varied by sociodemographic factors and access to health care (Pingali et al., 2023). Vaccination coverage by age 13 years among adolescents born in 2009 was similar to coverage estimates obtained before the pandemic.

Continued monitoring of vaccination coverage is needed to assess the post-pandemic recovery of routine childhood and adolescent vaccination coverage and inform vaccination catch-up efforts. While the NIS-Child and NIS-Teen provide population-based, state and local area vaccination coverage estimates among children and adolescents using a standard survey methodology, they report data collected from 1 to 3 years prior to the data release and county-level data are not readily available due to sample size challenges (Hill et al., 2023; Pingali et al., 2023). Analyzing the number of vaccine doses ordered by health care providers can be a useful approach to estimate vaccine availability, demand, access, and vaccine uptake. While vaccine ordering does not equate to vaccine administration, ordering data have the advantage of being available in near real time and at local-level. In addition, vaccine ordering data include the universe of all doses ordered rather than a sample used to assess vaccination coverage.

Although the impact of COVID-19 pandemic on routine childhood and adolescent vaccination during the early months of the pandemic has been examined, current vaccination coverage data, especially local-level data, are limited and progress on recovery of childhood and adolescent vaccine ordering has not been assessed. To assess national- and state-level recovery in childhood and adolescent vaccine ordering made following the early period of the pandemic and to inform vaccination efforts to ensure children and adolescents are up-to-date with all vaccines, monthly doses of the following vaccines ordered during and prior to the pandemic were examined: 1) Measles-containing vaccines which include two vaccines: Measles, Mumps, and Rubella (MMR) vaccine (brand name: M-M-R®II [Merck & Co., Inc., Rahway, NJ, USA]) and Measles, Mumps, Rubella, and Varicella (MMRV) vaccine (brand name: ProQuad® [Merck & Co., Inc., Rahway, NJ, USA]) and 2) human papillomavirus (HPV) vaccine (brand name: GARDASIL®9 [Merck & Co., Inc., Rahway, NJ, USA]).