Disappointing Children Vaccination Rates

Worldwide, infant mortality has long been the key measure of a country’s public health status.

The World Health Organization (WHO) reports immunizations currently avert an estimated 2 to 3 million deaths every year from illness, disability, and death from vaccine-preventable diseases.

But, the global vaccination coverage has stalled at 86 percent, with no significant changes reported during 2017.

This is important because an estimated 19.5 million infants are still missing out on basic vaccines, says the WHO.

In the USA, vaccination rates are impacted by both school requirements and personal preferences.

During the 2016–17 school year, kindergarten vaccination coverage approached 90%, and the median exemption rate among children attending kindergarten was 2 percent, reported to the Centers for Disease Control and Prevention (CDC).

A recent CDC infant vaccine coverage report collected data from approximately 3,973,172 kindergartners, exemption data for approximately 3,666,870, and provisional enrollment data for approximately 2,463,131.

This 2017 disease/vaccine segmentation was reported to be:

• Diphtheria, Tetanus, Pertussis (4+ doses DTP, DT, or DTaP): 84.6%
• Polio (3+ doses): 93.7%
• Measles, Mumps, Rubella (MMR) (1+ doses): 91.9%
• Haemophilus influenza type b (Hib) (primary series + booster dose): 82.7%
• Hepatitis B (Hep B) (3+ doses): 92.6%
• Chickenpox (Varicella) (1+ doses): 91.8%
• Pneumococcal conjugate vaccine (PCV) (4+ doses): 84.1%
• Combined 7-vaccine series: 72.2%

Additionally, immunization rates substantially vary by state, and within states, reports the CDC. 

Four states, California, New York, North Dakota, and Tennessee, reported increases in coverage of greater than 1.5 percentage points, for all reported vaccines.

As an example, California reduced new, non-medical exemptions for kindergartners attending public or private schools, from 4.4 percent to 1.9 percent.

But, in certain Texas school districts, vaccine exemptions are actually increasing.

Which is bad news regarding the goal of achieving ‘herd-immunity”.

Texas reported 44,716 “conscientious exemptions” in 2015-16, according to the Texas Department of State Health Services (DSHS).

Of Texas schools responding to the 2016-2017 DSHS report, 52,756 kindergarten through 12th-grade students were reported as having conscientious exemptions on file.

This represents a 17% "conscientious exemptions' increase in one school year, according to this Texas DSHS survey.

Two Texas school districts in Travis County, Eanes (3.6%) and Lake Travis (3.2%), reported vaccination exemption rates almost quadrupled in 2016.

On an individual school basis, data for Austin Waldorf School shows roughly 49 percent of the school’s students received conscientious exemptions during the 2016-17 school year, reports Community Impact.

This data indicates that the immunization safety net is not reaching all Texas children.

This fear turned into reality in January 2018.

Just 160 miles north of Austin on I-35 is Waxahachie, where the Texas DSHS reported 6 confirmed cases of measles in unvaccinated individuals.

In Texas, a signed affidavit must be presented by the child's parent or legal guardian, stating that the child's parent or legal guardian declines vaccinations for reasons of conscience, including because of the person's religious beliefs.

The CDC says ‘vaccine coverage could be increased with the implementation of evidence-based interventions, such as provider reminders to eliminate missed opportunities to vaccinate, standing orders to provide vaccination whenever appropriate, and the use of the Immunization Information System to track vaccination administration.’