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In 67% of the nation's census tracts, containing 52% of the 11,654 shooting incidents involving children, the average tract fell in the highest quartile of the Social Vulnerability Index. A statistical association was found between a one-decile increase in the SVI and a 45% increment in pediatric firearm-related injuries across all the included cities (Incident Rate Ratio 1.45, 95% Confidence Interval 1.41-1.49, p 0.0001). Each urban center displayed a similar