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I have written previously about the need to get an annual flu shot (my wife and I got ours two weeks ago), human papilloma virus, shingles, and other types of vaccinations, but that “trust in vaccinations appears to be declining, especially in small pockets of people living in insular communities. This puts under-vaccinated children at risk for contracting preventable diseases.”
I also noted that “vaccination, along with the discovery of antibiotics, is one of the major public health success stories in the history of medicine. Despite this, the incidence of vaccine-preventable diseases such as whooping cough and measles, after falling to all-time lows, has begun to increase.”
The potential consequences expressed in those statements are becoming apparent. Recent data from the Centers for Disease Control and Prevention published in the Morbidity and Mortality Weekly Report show that 1.3 percent of children born in 2017 did not receive any vaccinations. This represents a four-fold increase from 0.3 percent in 2001.
The Advisory Committee on Immunization Practices recommends routine vaccination against multiple potentially serious illnesses, including hepatitis A and B, rotavirus, diphtheria/tetanus/ pertussis, influenza, pneumococcus, polio, measles/mumps/rubella, varicella, meningococcus, and HPV.
However, the falling vaccination rate means that an estimated 100,000 young children have not been vaccinated against any of these diseases. Children in rural areas and those without insurance have higher rates of not being vaccinated.
While these results are sobering, recent overall vaccination coverage among young children remains high, and most children are routinely vaccinated.
Since the number of children who have received no vaccinations by age 24 months has been gradually increasing, the results highlight areas for improvement, such as educating parents who refuse to let their children become vaccinated and creating vaccination opportunities for rural populations and the uninsured. It is important to stress that most of the vaccines require more than one dose, with many of those multiple doses administered in the first year of life. We need to place greater emphasis on those vaccines that require booster doses.
The increasing percentage of unvaccinated children raise concerns about potential pockets of susceptibility where children are not well protected. For example, measles was declared eliminated from the United States in 2000, yet outbreaks caused by imported cases continue to occur each year; 118 measles cases were reported in 2017. The continued occurrence of measles outbreaks in the United States underscores the need to ensure high vaccination coverage among all young children.
Vaccines work not only by inoculating individuals from contracting a disease but also by creating herd immunity. When more than 80% to 90% of a population is vaccinated, chains of infection are likely to be disrupted, stopping or slowing the spread of disease, which protects those few not vaccinated. Therefore, not immunizing the few can affect the many.
Reduced vaccination rates around the world can cause outbreaks among Americans, as under-vaccinated Americans may become infected while visiting places with weaker herd immunity and carry the virus or bacteria back to the states. International travel also provides the opportunity for infected individuals to come in contact with susceptible Americans.
We can do better. Preventing disease is far preferable (and cheaper) than having to treat it after it occurs.
Be smart. Prevent disease with appropriate immunizations — in your children and in yourself. The minimal risks and expense are far less than contracting and treating the disease.
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