- Early vaccination timing is a critical warning sign. Patients who receive their 2-month vaccines late have nearly 7 times the odds of missing MMR entirely by age 2. This makes delayed early vaccines a powerful predictor—flagging these families early allows for targeted outreach and intervention.
- Declining coverage is happening even among engaged patients. MMR nonvaccination by age 2 rose from 5% to 8% between 2020 and 2024 in children with regular healthcare access. This suggests vaccine hesitancy, not access barriers, is driving the trend—requiring different conversations than simply removing logistical obstacles.
- Well-child visit adherence matters. Following the AAP well-child schedule was associated with substantially lower odds of nonvaccination. Emphasizing the importance of these visits and using them as vaccination touchpoints can help keep patients on track
Source: JAMA Network Open
