Low Immunization Rates

What's the Problem?

Twenty percent of the nation's two-year-olds are missing one or more recommended immunizations. The 11,000 babies who are born will require 16 – 20 doses of vaccine before age two. Many parents don't understand what it takes to get their children immunized and what diseases can be prevented. Since they have never seen these diseases and the devastation they can cause, they have less concern about the need for immunization compared to other parental priorities.

Vaccine-preventable diseases such as polio, chickenpox, whooping cough, measles, and diphtheria are not diseases of the past. They are still circulating either at low levels in the United States or at epidemic levels elsewhere in the world – only a plane ride away. Someone leaving India yesterday could very easily pass along the polio virus to unvaccinated children in the United States today. If vaccination coverage levels drop, we can expect a resurgence of many of these diseases, along with the suffering and death that they can cause. Immunizations are one of best ways that parents can protect their children against serious diseases.

Who's at Risk?

Infants and young children are particularly vulnerable to complications from vaccine-preventable diseases. That is why vaccination is critical. High immunization coverage levels protect not only the individual but the entire community by reducing the spread of infectious agents to those who have not been vaccinated or those who cannot be protected by vaccines (e.g., children too young to receive all the recommended doses or children with diseases such as leukemia).

Can It Be Prevented?

Yes. Vaccination rates can improve if parents know the importance of vaccination and the possible tragic consequences of failing to vaccinate. Vaccinations protect against childhood illnesses that can be very serious, and even deadly.

Immunization coverage among children in the United States is the highest ever recorded for most vaccines. As a result, these serious diseases among children have dropped by 95% or more.

However, prevention efforts depend on high levels of vaccine coverage. For example, each year the United States is hit with multiple importations of measles. Measles is no longer circulating in the United States, but the virus is frequently imported from outside this country. If vaccination coverage levels drop, there will be a resurgence of measles. The 1989-91 measles epidemic demonstrates what can happen. In 1988, measles was considered to be under control. Incidence was relatively low, only 3,396 cases. Pockets of under-immunized preschool populations were believed to serve as reservoirs for measles, but, there seemed no reason for urgency and immunization levels dropped. The complacency led to more than 55,000 cases of measles, more than 11,000 hospitalizations, and more than 120 deaths in the three years from 1989 to 1991. Similar consequences are possible with any vaccine-preventable disease if immunization levels drop.

Tips for Scripts

• EDUCATE parents about the importance of immunization and what can happen if children are not vaccinated.
• INFORM viewers that vaccine-preventable diseases caused hundreds of thousands of cases of illness and thousands of deaths every year in the United States before the 1920s when vaccines were not available. Cases of measles, diphtheria, and pertussis exceeded half a million per year; deaths from these diseases totaled about 20,000 annually. Hib meningitis used to strike 12,000 children a year, leaving many either dead or with permanent brain damage.
• REASSURE viewers that we can now protect children from eleven diseases. Polio has not circulated in the U. S. since 1979, and disease and death from diphtheria, pertussis, tetanus, measles, mumps, rubella, and Haemophilus influenzae type b are at or near record lows.
• REMIND viewers that children should not have to suffer and possibly die from a vaccine-preventable disease and that their doctor or clinic can advise them on childhood immunization schedules beginning within the first year of life

Case Examples

1. A one-year-old inner city child dies of an infection of unknown origin. Rumors spread through the community that the infection was caused by a vaccine recommended by the government. The rumors take on ominous tones, including government-sponsored genocide. As a result of these rumors and a general distrust of the government/medical establishment, many parents refuse to have their children immunized. The local hospital sees an alarming increase in serious vaccine-preventable diseases. Whooping cough, which is especially bad in young babies, and measles spread through the community; a number of children die. The doctors struggle with the crisis as the number of deaths increases. Unfortunately, the rumors continue to fly, and it takes community meetings, educational programs, and doctor visits to PTA meetings before confidence in vaccines is renewed and rates of disease and death start to decline.
2. A parent hears that a child in the neighborhood has whooping cough and calls neighbors to see what they are doing to protect their children. She learns about the childhood immunization schedule and where she can receive free care to protect all of her children from many potentially fatal diseases.