Good News on Baby Shots, But… (Article)

We still have more children to immunize as the recent Disney measles outbreak demonstrates, but there is great cause for celebration by pediatricians and public health officials: vaccination rates among young children are actually quite high. From 2012-2013, many of the most important vaccines for young children such as the measles vaccine (MMR), hepatitis B vaccine, poliovirus vaccine, and chicken pox vaccine have been administered to over 90% of children aged 19 -35 months. It is estimated that this level of vaccination in children born between 1994 and 2013 will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths during these children’s lifetimes.  What a tremendous achievement! But it is too early to rest on our laurels. In order to get the maximum benefit from vaccines for our children, we need to continue to improve vaccine delivery for every child. Currently, we are having problems getting the children of families with either very low and very high incomes vaccinated.
 

Even though vaccine coverage is increasing for most children, a recent National Immunization Survey (1) indicates that many children who live below the poverty line are not getting all the vaccines they need in a timely fashion. This problem is especially evident in rates of follow-up vaccines for those vaccines that require more than one round of treatment, such as DTaP (for diphtheria, tetanus, and whooping cough) and PCV (for prevention of pneumococcal infections). Children in lower income households frequently miss their wellness check-ups that are crucial in delivering vaccines, thus contributing to the decline. Purposeful steps must be taken to ensure that these children do not fall through the cracks.
 
Thankfully, there are new programs and systems available to boost vaccine rates in children. The “Vaccines for Children” program has reduced the disparity in vaccination rates for children in lower income households by providing free vaccines to private doctors who provide services to lower income families. Educating parents on the risks of missed vaccines and the long-term benefits of proper vaccination for their children is also key to increasing vaccine rates. Hopefully, the recent surge in cases of measles will serve as a reminder to parents to get their children immunized. Finally, it is hoped that by using national media campaigns, telephone reminder systems, and computer-based vaccine databases, parents and doctors will decrease the missed opportunities to vaccinate. If your child or the child of someone you know has missed a vaccine, schedule an appointment with your child’s doctor as soon as possible. Let’s raise that vaccine rate to a nice even 100%, shall we? With everyone’s help, we can.
 
Your comments are welcome at my blog, www.docsmo.com. Until next time.
 
Smo Notes:
 
1. National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2013
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6334a1.htm?s_cid=mm6334a1_e
2. Rich People in Hollywood aren’t Vaccinating their Children, by Kara Brown, September 2014
http://jezebel.com/rich-people-in-hollywood-arent-vaccinating-their-childr-1633139304
Written collaboratively by Keri Register and Paul Smolen M.D.

2 Comments

  1. Mom of four says:

    I am a mother of three and soon to be four this January. Dr Smolen has been out trusted pediatrician for 10 years. My question is related to vaccines. We as a family are all vaccinated. We do however have school age cousins in our family that are not vaccinated. I am very concerned about unvaccinated children around our newborn. Can you give me your opinion on how you would handle this situation? Also do you have any advice if we should let known unvaccinated children around our new born? Thank you so much for any insight.

    • DocSmo says:

      Unfortunately, I believe you do have reasons to be concerned. During your new baby’s first year of life, until the new baby has received the HIB meningitis vaccine, the pertussis vaccine (also known as whooping cough vaccine) and the measles vaccine, I believe your new baby is taking more risk than they should. HIB meningitis, whooping cough, and measles are all deadly illnesses. Your cousins are getting their immunity the natural way, through periodic natural infections and fortunately they have been able to remain healthy. During their periodic infections however, they could easily infect and harm your new baby. Once your new baby has had the first year vaccines, it should be safe for your infant to be around your cousins since he or she will be protected by the vaccines they recieved.

      How to handle the family situation is a little trickier. I believe that honesty is always the best approach. I would tell your cousins of your concerns, and since they have chosen not to vaccinate their children, you prefer not to take a risk of inadvertent infection from exposure to their children in the first year of life. After that, group activities with your cousins will be fine since the risks will be very small at that point. Your cousins may counter with, “Well, your new baby may be around unvaccinated children at the grocery store or at church!” True, but these are not household exposures, brief in nature, and not ones that as Mom are choosing. They are right, there is risk in any public exposure but much less than being exposed to unvaccinated children in a household contact manner.

      Tough situation but I think you can handle it. At the end of the day, you have to do what is best for your family. Hopefully they will understand and be gracious. I guess we will see. Good luck.

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