Vaccines are one of the most effective tools available for the prevention of childhood diseases. As such, the Advisory Committee on Immunization Practices recommends routine vaccination by the age of 24 months for 14 potentially serious illnesses.
Recent data from the Centers for Disease Prevention and Control shows that coverage with most recommended vaccines remained stable and high in 2017 among children aged 19-35 months across the United States.
For example, total coverage exceeded 90 percent for the recommended doses of poliovirus, MMR (measles, mumps and rubella), hepatitis B and varicella (chickenpox) vaccines.
However, children were least likely to be up to date with the recommended doses of hepatitis A vaccine (59.7 percent coverage), rotavirus vaccine (73.2 percent) and the combined 7-vaccine series (70.4 percent.)
Furthermore, the report found that while the proportion of children who had received no vaccine doses by 24 months was low, it had increased gradually from 0.9 percent for children born in 2011 to 1.3 percent for the cohort born in 2015.
In fact, the data shows that the percentage of American children aged under two who have received no vaccinations has quadrupled since 2001.
The report also showed how coverage varied depending on a number of factors, including state, rural/urban location, ethnicity, poverty and insurance status.
For example, children living outside so-called “Metropolitan Statistical Area principal cities” had a higher prevalence of unvaccinated children (1.9 percent) compared with children in these areas (1.0 percent.) Meanwhile, coverage was lower among uninsured or Medicaid-insured children.
There were significant variations among states. For example, estimated rotavirus coverage ranged from 64.7 percent in California to 85.1 percent in Rhode Island. Meanwhile, coverage with MMR ranged from 85.8 percent in Missouri to 98.3 percent in Massachusetts.
According to the CDC, some children might be unvaccinated because of choices made by parents, whereas for others, lack of access to health care or health insurance might be factors. The authors of the report say this latest research has several implications.
“Collaboration with state immunization programs, eliminating missed immunization opportunities, and minimizing interruptions in insurance coverage are important to understand and address coverage disparities among children eligible for the Vaccines for Children program and those in rural areas,” the researchers wrote in the report.
Barbara Dale, a school nurse, prepares an immunization needle for a child in Hialeah, Florida, on August 8, 2007. The percentage of American children under two years of age who have received no vaccinations has quadrupled since 2001. Joe Raedle/Getty Images
Another recent study found, published in the journal PLOS ONE, found that a social movement of public health vaccine opposition has been growing in the United States in recent years.
“Since 2009, the number of “philosophical-belief” vaccine nonmedical exemptions (NMEs) has risen in 12 of the 18 states that currently allow this policy: Arkansas (AR), Arizona (AZ), Idaho (ID), Maine (ME), Minnesota (MN), North Dakota (ND), Ohio (OH), Oklahoma (OK), Oregon (OR), Pennsylvania (PA), Texas (TX), and Utah (UT),” the PLOS ONE study authors wrote in their paper.
This movement has created several “hotspot” metropolitan areas which stand out for their very large numbers of NME’s.
These include King County, WA, Spokane County, WA, and Multnomah County, OR, in the Northwest; Maricopa County, AZ, Salt Lake County, UT, Utah County, UT, Harris County, TX, Tarrant County, TX, Collin County, TX, and Travis County, TX, in the Southwest; and Oakland County, MI, Macomb County, MI, Wayne County, MI, and Jackson County, MO, in the Midwest.
Below is a list of the states with the lowest estimated vaccination coverage (for selected vaccine types listed in the CDC study) among children aged 19-35 months:
Missouri – 85.8
Indiana – 87.0
Colorado – 87.2
DTaP (diphtheria, tetanus toxoids and acellular pertussis vaccine)
Alaska – 75.1
Missouri – 77.0
Wyoming – 77.6
Missouri – 43.9
Wyoming – 46.4
Mississippi – 49.8
California – 64.7
Nevada – 66.0
Ohio – 67.2
Combined 7-vaccine series
Georgia – 65.6
South Carolina – 66.0
Minnesota – 66.1
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