Decline in measles vaccination rate among kindergartens raises alarm

More than 250,000 children starting kindergarten in the fall of 2021 may be at risk for measles, one of the most contagious pathogens on the planet, because they don’t receive the necessary vaccinations to enroll in school, according to federal health data released Thursday.

Only about 93 percent of American kindergarten students were vaccinated with the two required doses of the potentially deadly disease — for the second year in a row, measles mumps and rubella (MMR) coverage fell below the 95 percent level needed to prevent the virus from spreading. society. US kindergartens last had this protection in the 2019-2020 school year, before the pandemic began.

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The Centers for Disease Control and Prevention report also shows the continued decline in vaccination rates for three other childhood vaccines that prevent diphtheria, tetanus and pertussis (DTaP), polio and chickenpox among kindergarteners in 2021.

The latest data underscore concerns that growing parental resistance to routine childhood immunizations is fueling a resurgence in vaccine-preventable diseases, such as the recent measles outbreaks in Minnesota and Columbus, Ohio, which sickened more than 100 children last year. The pandemic has exacerbated the problem due to the politicization around coronavirus vaccines and the lasting consequences of school closures and fewer children going to the doctor about vaccination rates.

“We know that measles, mumps and rubella vaccine coverage for kindergartens is at its lowest in a decade… and that’s something to be concerned about,” Georgina Peacock, CDC’s director of immunization services, said at a briefing. .

While a two percentage point drop in measles vaccination rates may seem insignificant, health officials and experts warn that even the smallest drop could allow the virus to spread faster, causing outbreaks in clusters of unvaccinated children. Measles is so contagious that people who may not know they have been exposed can become infected and spread the virus to family members or other contacts before they show symptoms.

Besides being potentially deadly, the measles virus weakens the immune system and makes the child more vulnerable to other illnesses such as pneumonia and diarrhea – this effect lasts for months after the body clears the measles infection.

Federal data shows nine states and the District of Columbia where vaccination coverage among kindergartens is below 90 percent, including Ohio and Minnesota. This is the largest number of states to fall below this level in data released by the CDC dating back to 2009-2010. New York, Nebraska, North Carolina, and Tennessee are among 12 states with MMR vaccination rates above 95 percent.

Kindergarten coverage for all four childhood vaccines to prevent measles, diphtheria, tetanus, and pertussis (DTaP), polio, and chickenpox has increased from 94 percent in 2020-2021 to nearly 93 percent nationwide in the 2021-2022 school year. dropped to 95. percent in 2019-2020.

The decline means more than 275,000 kindergarteners may not be fully protected against these diseases, according to the CDC.

All states and the District of Columbia require children to be vaccinated against certain diseases, such as measles, polio, and whooping cough, in order to attend public school. All grant exemptions for medical reasons; A growing number also allow religious or philosophical exemptions.

There are several factors behind the decline. Pandemic-related disruptions in the healthcare system have delayed pediatric visits. Partly as a result, providers ordered fewer doses than the federal program, which provides the vaccine for half of all American children. In some cases, schools also lack staff to ensure that parents submit their health documents on time.

And concerns about the value of the coronavirus vaccine are increasingly reflected in routine vaccinations.

“The Covid vaccine, in some cases, affects whether people choose to have other routine vaccines,” said Peacock of the CDC. “When we think about vaccination confidence and motivation to get vaccinated, it depends on a lot of things. The easier it is to vaccinate your child, the more likely you are to get it.”

Pointing to recent measles outbreaks in Ohio and Minnesota, preventable diseases were spreading rapidly, he said.

The CDC recommends that children get two doses of MMR vaccine, with the first dose at 12 to 15 months of age and the second dose at 4 to 6 years of age. One dose of the vaccine is approximately 93 percent effective in preventing measles; Two doses are about 97 percent effective.

In the Columbus outbreak, most of the 83 infected children were old enough to be vaccinated, but their parents chose not to do so, resulting in the nation’s largest outbreak of the highly contagious pathogen in 2022. Authorities will likely declare the outbreak to be over, Columbus health department spokesperson Myles Bell reported on Jan.

Minnesota reported 22 measles cases between June and November last year, but these occurred in several clusters. This pattern was more alarming than a major epidemic like the state experienced in 2017.

“The swarms remained closed like small campfires, but each had the potential to escalate into a wildfire that could have vastly more serious consequences,” said Doug Schultz, spokesman for the Minnesota health department. Health officials said vaccine indecision was a contributing factor in both outbreaks.

Peacock also cited a case of paralytic polio in a New York man this summer, raising concerns that low childhood vaccination rates and increasing vaccine misinformation could lead to a resurgence of the disease decades after vaccination eradicated it in the United States. .

“I think this is all evidence that we have pockets in the United States, where vaccine coverage among children is low, as well as in these particular communities that are increasing vaccination rates,” Peacock said.

The CDC launched an initiative this week to return routine vaccinations for adults and children to the schedule. Authorities are giving healthcare providers more information and strategies to help them talk about vaccines and work more intensely with community groups in areas where vaccination rates are very low.

Rupali Limaye, associate professor of vaccine indecision at Johns Hopkins University, said the overall decline in childhood immunization rates is alarming, and the decline in measles vaccination in particular is dangerously low and “highly alarming”.

He has spoken to hundreds of parents, churches, and other community groups about the coronavirus vaccine over the past three years. He said many people may not have had problems with the routine immunization schedule prior to the pandemic. But the confusing messages that kids should get the coronavirus vaccine “influenced their decision to get these routine vaccines,” Limaye said.

Immunization advocates say it’s difficult to raise vaccination rates without a clear understanding of why they’re falling.

“Most recent surveys show parents still overwhelmingly support childhood immunizations, so is it an awareness issue?” asked Erica DeWald, strategic communications director for the vaccination advocacy group Vaccinate Your Family. “Or do we need to identify access issues as a result of the pandemic? We need to continue collaborating with community partners to identify and address key barriers to vaccination.”

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