Borrowing Proven Policy Strategies to Vaccinate Kids Against COVID-19

Lessons from past successes can provide a roadmap for ensuring equity in immunization efforts.

Doctor examines a young boy.

With authorization of the first COVID-19 vaccine for children ages five and older, most kids in the United States are now eligible to be immunized.


The Issue

Recent experience with other vaccines shows the country is capable of vaccinating kids widely and equitably, but the challenges in vaccinating adults against COVID-19 and experiences with other immunizations in children, like the vaccine against the human papillomavirus (HPV), also demonstrate that success is not inevitable. To meet their COVID-19 vaccination goals to vaccinate kids against COVID-19, states can borrow strategies that have historically proved effective in immunizing kids against diseases such as measles and resulted in dramatic reductions in certain vaccination rate disparities.

The issue brief, Borrowing Proven Policy Strategies to Vaccinate Kids Against COVID-19, highlights strategies that have led to high childhood vaccination rates—and dramatic strides toward health equity—and it identifies how those strategies could be applied in the context of the current COVID-19 crisis.

Key Findings

  • The United States has reached childhood vaccination rates above 90 percent for diseases such as measles, and it has nearly eliminated racial and ethnic disparities for certain vaccines.

  • States can leverage children’s higher rates of health insurance to facilitate COVID-19 vaccination in traditional healthcare settings, where clinicians can educate parents and kids on vaccine benefits and administer them immediately.

  • Vaccines for Children-enrolled providers, credited with much of the progress in improving vaccination rates and reducing disparities, offer a ready infrastructure for immunizing uninsured and under-insured children.

  • Covering nearly one-third of kids nationwide, state Medicaid programs can promote vaccination by setting COVID-19 immunization rate targets for Managed Care Organizations and healthcare providers.

  • States can disseminate and encourage evidence-based practices, such as the 4 Pillars Immunization Toolkit, that research has shown effective in helping healthcare providers to improve immunization rates.

  • Studies show that immunization requirements for children to attend schools or childcare result in higher vaccination rates, and communities with robust mandates have fewer unvaccinated kids and are less likely to suffer disease outbreaks.


Unlike for adults, the United States has a proven playbook of tools and strategies for vaccinating children widely and equitably. To protect children and communities against COVID-19, states should borrow those evidence-based strategies. If not, they risk seeing child COVID-19 vaccination rates languish at low levels and with notable disparities—and seeing the largely preventable consequences of the pandemic persist within under-vaccinated communities. 


About State Health and Value Strategies—Princeton University Schools of Public and International Affairs

State Health and Value Strategies (SHVS) assists states in their efforts to transform health and healthcare by providing targeted technical assistance to state officials and agencies. The program is a grantee of the Robert Wood Johnson Foundation, led by staff at Princeton University’s School of Public and International Affairs. The program connects states with experts and peers to undertake healthcare transformation initiatives. By engaging state officials, the program provides lessons learned, highlights successful strategies and brings together states with experts in the field. Learn more at

About State Health Access Data Assistance Center, University of Minnesota

This issue brief was prepared by Colin Planalp. The State Health Access Data Assistance Center (SHADAC) is an independent, multi-disciplinary health policy research center, housed in the School of Public Health at the University of Minnesota, with a focus on state policy. SHADAC produces rigorous, policy-driven analyses and translates its complex research findings into actionable information for states.