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Vaccines Prevent Disease and Death – Why Are Some US Children Not Vaccinated?

MedicalResearch.com Interview with:
"Vacuna influenza / Flu vaccine" by El Alvi is licensed under CC BY 2.0Kathryn M. Edwards, M.D.
Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics
Professor of Pediatrics
Vanderbilt University School of Medicine

Dr. Edwards discusses the statement from the Infectious Diseases Society of America (IDSA) regarding the Centers for Disease Control and Prevention’s new data on child vaccine rates across the United States.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: To monitor the uptake of vaccines the CDC conducts a National Immunization Survey each year.  This survey is conducted by random-digit dialing (cell phones or landlines) of parents and guardians of children 19-35 months of age.  The interviewers ask the families who provides the vaccines for their children and if these providers can be contacted to inquire about the immunizations received.  The overall response rate to the telephone survey was 26% and immunization records were provided on 54% of the children where permission was granted.  Overall 15, 333 children had their immunization records reviewed.

When comparing immunization rates for 2017 and 2016, the last two years of the study, several new findings were discovered.

First the overall coverage rate for 3 doses of polio vaccine, one dose of MMR, 3 doses of Hepatitis b, and 1 dose of chickenpox vaccine was 90%, a high rate of coverage.  Children were less likely to be up to date on the hepatitis A vaccine (70%) and rotavirus vaccine (73%). Coverage was lower for children living in rural areas when compared with urban areas and children living in rural areas had higher percentages of no vaccine receipt at all (1.9%) compared with those living in urban areas (1%).

There were more uninsured children in 2017 at 2.8% and these children had lower immunization rates.  In fact 7.1% of the children with no insurance were totally unimmunized when compared with 0.8% unimmunized in those with private insurance. Vaccine coverage varies by state and by vaccine.

MedicalResearch.com: What accounts for most of the disparities in childhood vaccinations rates in the US? What are the main vaccines that children are missing?

Response: Vaccination coverage is lower for uninsured and those who are Medicaid insured and these disparities are larger for those vaccines that require a booster dose in the 2nd year of like such as DTap, Hib, and PCV.  The coverage differences are concerning since all children should be eligible for VFC. But barriers to access to VFC and access to care need to continue to be assessed. The shortage of providers for children in the rural areas might also be part of the problem.

The immunization rates for rotavirus and hepatitis A remain the lowest, as mentioned above.

MedicalResearch.com: What can be done to improve childhood vaccination rates?

Response: Access needs to be available for all children, parents need to understand the importance of vaccines and the major role that they play in keeping children healthy,  providers need to be able to knowledgeably address the questions that parents have about vaccines and their impact, and missed opportunities for immunization need to be reduced.

MedicalResearch.com: Is there anything else you would like to add?

Response: No disclosures. But just want to add that as a provider I am fully immunized and my children and grandchildren are immunized.  Vaccines prevent disease and death.


  1. Mellerson JL, Maxwell CB, Knighton CL, Kriss JL, Seither R, Black CL. Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2017–18 School Year. MMWR Morb Mortal Wkly Rep 2018;67:1115–1122. DOI: http://dx.doi.org/10.15585/mmwr.mm6740a3.

2. Vaccination Data Highlight Needs for Strengthened Efforts
10/15/2018 Infectious Diseases Society of America

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Last Updated on October 19, 2018 by Marie Benz MD FAAD