The Blue Cross Blue Shield Association Reports Steep Decline in Childhood Vaccinations Due to COVID-19 Pandemic, Putting Community Protection at Risk

An estimated 9 million childhood vaccination doses could be missed nationwide by the end of 2020

CHICAGO – Millions of children have missed routine vaccinations this year, causing a precipitous drop in immunizations that threatens to leave communities throughout the U.S. at risk of losing protection against highly contagious diseases, including measles, whooping cough and polio, according to new data from the Blue Cross Blue Shield Association (BCBSA).

As the COVID-19 pandemic prompted Americans to postpone or avoid receiving routine medical care, children are on track to miss an estimated 9 million vaccination doses in 2020, a decrease of up to 26% in childhood vaccination doses compared to 2019.

Global public health officials already are warning of a sharp increase in the number of new measles infections and deaths, with the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization and UNICEF saying that urgent action is needed to avert major measles and polio epidemics.

The new BCBSA vaccine data, based on medical claims from millions of Blue Cross and Blue Shield (BCBS) members, provides clear evidence that the United States is at risk of widespread outbreaks of preventable disease. If current trends continue, the U.S. would fall dangerously below the vaccination levels for measles and whooping cough that the CDC says are needed to protect community health.

“The U.S. is on the precipice of a severe immunization crisis among children,” said Dr. Vincent Nelson, chief medical officer at BCBSA. “The COVID-19 pandemic has significantly interrupted adherence to vaccination schedules, and the possibility that preventable diseases, like polio, could become a threat to public health once again is particularly concerning.”

According to the new BCBSA data, 40% of parents and legal guardians say their children missed vaccinations due to the pandemic. The majority of vaccination postponements occurred during two key time periods. The first was in March through May, when the pandemic was first taking hold. Then, in August, the typical spike in back-to-school vaccinations largely failed to occur because of the pandemic’s impact and the shift to virtual schooling options in districts across the country.

“These trends must be reversed,” Nelson said. “It is critical that parents and caretakers keep up with regular wellness visits and catch up on any previously missed vaccinations to keep children safe and ensure community protection against these highly contagious diseases.

“Family physicians, pediatricians and community health centers are well prepared and are taking measures to ensure their offices are safe. We urge parents to ensure all childhood vaccinations are up to date,” he added.

Below is a table that highlights trends in rates for key vaccinations against benchmarks the CDC has established for community protection:


BCBS 2020 Estimated Vaccination Rate

BCBS % Decrease from 2019

CDC Herd Immunity Requirements

BCBS 2020 Estimated Vaccination Rate vs. CDC Herd Immunity Requirements






Whooping Cough










BCBS companies support safe and effective vaccinations in the communities they serve and are adjusting their vaccine outreach due to COVID-19. To help spread vaccination awareness, BCBS companies continue to partner with the medical community, local health groups and others who support increased vaccinations and are able to adjust operations to accommodate new safety protocols due to the pandemic.

The findings come from a new BCBSA analysis of member claims data, which examined vaccination doses delivered from January to September 2020, compared to the same time period in 2019.

BCBSA is preparing a comprehensive analysis of childhood and adolescent vaccination rates, to be released in 2021 as part of its Blue Cross Blue Shield, The Health of America Report® series. Parents and legal guardians looking for additional information can reach out to their local BCBS company to find out what programs are available in their community. For more information, visit

All company names and brands are the property of their respective owners and used for identification purposes only and are in no way associated or affiliated with the Blue Cross Blue Shield Association. Use of these names and brands does not imply endorsement

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 35 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Indexsm. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on Facebook, check out our videos on YouTube and follow us on Twitter.

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.