A recent analysis in 2014 concluded routine childhood vaccination will prevent 322 million cases of diseases, approximately 732,000 early deaths, and have a net societal savings of $1.38 trillion among children born during 1994 to 2013 (Whitney, Zhou, Singleton, & Schuchat, 2014). Yet one child dies every 20 seconds from a vaccine preventable disease (CDC, 2018). As of 2015, the Centers for Disease Control (CDC) reported that more than 90% of children were up-to-date on their vaccinations. However, children below the poverty level and living in rural areas continually reported lower vaccination coverage. Focusing on Healthy People 2020 Leading Health Indicator of Clinical Prevention Services, the purpose of this study is to analyze how factors such as access to care, socioeconomic status, and vaccine-hesitant parents (VHP) affect vaccination rates for children between ages 19-35 months. Utilizing systematic review, research targeting access to care, socioeconomic status, and parental hesitancy in relation to vaccination rates among children ages 19-35 months were collected from PubMed, ScienceDirect, and Medline. Data ranged from 2013 to 2018 and excluded global data. Overall results showed a positive correlation between access to care and socioeconomic status and the initiation and completion of vaccination in the targeted population. Multiple studies utilized the Parent Attitudes about Childhood Vaccines survey (PACV) to distinguish VHP within a population. Results showed parents who scored 70 to 100 had children who were under-immunized for 46.8% more days than parents who scored less than 50 (Opel et al., 2013). The implementation of parental counseling, patient-physician communication, and opportunity intervention can be utilized to maintain and advance childhood vaccination coverage throughout the United States.