I know a little
Elizabeth, I think she is about a year old now. She has a sister named
Catherine. They go by
Elizabeth and Catie.
I know lots and lots and lots who are all 20+ years old. Almost all of the ones aged 20-40 go by
Lizzie exclusively. A few go by
Ellie. I also know one who goes by
Libby.
Of the ones who are 40+ many go by
Beth or
Liz. I also know one who goes by
Betty.
The little one year old is the only one who goes by her full name. I think you don't hear the full name very much and the reason why it stayed common for so long is because the nicknames went in and out of style and the full name stayed a classic without sounding dated.
Personally I think it is starting to sound a bit tired, kind of like
Katherine. I also think that like
Katherine and
Mary which were common for ages it will soon fall.
Ohhh and I wouldn't use it as a middle name, it is one of the most common middle names ever together with
Rose,
Anne and
Marie. I know so many! I know two
Ava Elizabeths who were born recently, and many many more. It is THE filler middle name of the 80s and 90s, in my opinion, and still being used a lot.
Alice Elizabeth -
Alice needs a more interesting middle name. It doesn't flow well because of the -li sounds that are repeated in the combo and sound very similar.
Ophelia Elizabeth - this works because
Ophelia is uncommon and it flows. But it is still overused in the middle in general.
Imogen Elizabeth - same
Elizabeth Margot - this works
Elizabeth Caroline - this doesn't because
Caroline is also common. I would always pair
Elizabeth with something a bit unusual.
Oh and I am surprised it was still in the top 10 or 20 in the past 20 years because pretty much all the Elizabeths I know are 20+.