Why does the US have high unvaccinated rates among children?

The unvaccinated rate among children in the United States has dropped dramatically, but not to historic lows, according to the annual national Immunization Survey, released by the Centers for Disease Control and Prevention (CDC) in its newly released July 2018 report.

This year, 15.3% of all children were not vaccinated as of April 1, 2018. That is the lowest percentage recorded by the CDC since it began releasing its survey data in 1996. However, it is still higher than in the first half of 2017.

Dr Sarah Leonard, medical director of the CDC’s Immunization Safety Office, emphasizes the variability of the data by state.

“In every state, we are not seeing a significant change in percentage of unvaccinated versus vaccinated kids, but the differences in the rates vary quite a bit, and that adds up to a statistically significant percentage difference,” she says.

The vaccination rate declines coincide with an increased worry about the rising number of illnesses and complications among children as a result of unvaccinated children. In fact, at the height of the measles outbreak that led to 128 cases in late 2017 and early 2018, it was one of the most significant public health threats of 2018.

During the summer of 2018, 15 states had more than 9% of children in their population unvaccinated. The majority of states with high unvaccinated rates are in the south and southeast, according to the report.

This increased concern about vaccines means that many families are intentionally delaying or refraining from vaccinations. Leonard recommends that parents should seek out additional information from the experts when deciding on their children’s vaccine schedule.

“It’s important that the unvaccinated and the vaccinated have different views on vaccine safety,” she says. “We need to understand how much vaccine is enough and where we stand on a balanced patient-based approach.”

Some vaccines can be spaced one month apart for the benefit of infants and other age groups. Other vaccines (such as the mumps, rubella and hepatitis A vaccines) can be done in two doses spaced at different ages.

Another concern is that the recent state and federal shutdown of several national vaccination programs may have impacted those vaccinating their families. The state of Hawaii halted its childhood immunization program due to lack of funding, and 30 states and the District of Columbia experienced a decrease in immunization clinics, according to a report in the New England Journal of Medicine.

The report also notes that state-level variations in the vaccination rates can reflect parental concerns about vaccines. In fact, more parents may be delaying or refusing vaccine because of the recent controversies over whether some vaccines cause autism, or about vaccine preservatives.

The Center for Disease Control and Prevention’s JAMA article “Local Immunization Coverage in the United States: 2017” estimates the number of children who have not had their measles vaccination since the Measles, Mumps and Rubella (MMR) vaccine was first recommended in 1963. The number of children who have not had their MMR vaccine declined from 18% in 1990 to 13% in 2001, but has since doubled to 23% in 2014.

This information can help parents make informed decisions about vaccination schedules for their children. Consider your own personal preference, as well as the recommendations from your medical team, and make sure you are getting the vaccine recommended for your child. Most infectious diseases can be prevented with vaccines.

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