The United States Centers for Disease Control and Prevention in its Morbidity and Mortality Weekly Report (MMWR) for August 24, 2012 reported that most kindergartners in the United States received their recommended vaccines for measles and other diseases during the 2011-12 school year but that unvaccinated clusters continue to pose a health risk. Overall, 47 states and DC reported 2011–12 school vaccination coverage, median MMR vaccination coverage was 94.8%, with a range of 86.8% in Colorado to 99.3% in Texas. Four states reported <90% MMR vaccination rates: Colorado, Idaho, Kansas and Pennsylvania.
Median coverage with 2 doses of varicella vaccine among 33 states reporting vaccination rates was 93.2%, with a range of 84.0% in Colorado to 99.2% in Mississippi and Texas. The median coverage levels for DTaP, poliovirus, and HepB vaccines all were at or above the Healthy People 2020 target of 95%, with only a few states falling below the 90% rate on any one of the vaccines, including Colorado and Idaho. (You can see the full vaccination report by state here.)
According to the CDC report, vaccination exemption rates in the 49 states and DC that provided exemption information for the 2011–12 school year, 10 states reported <1%, and nine reported >4% total exemption rates, with a range of <0.1% in Mississippi to 7.0% in Alaska. An estimated 89,133 exemptions were reported, for a total estimated population of 4,124,185 kindergarten children, or a median total exemption level of 1.5%, a median increase of 0.2 percentage points compared with the 2009–10 school year. The graphic below shows the exemption rate by state throughout the US. Note that the Northwest and upper midwest has some of the highest exemption rates, where the current whooping cough epidemic has been centered.
According to the CDC, “Sustaining high vaccination coverage among school children is vital to prevent outbreaks and avoid reestablishment of diseases that have been eliminated in the United States. The median MMR and 2-dose varicella vaccination coverage levels for children entering kindergarten for the 2011–12 school year were below theHealthy People 2020 target of ≥95%. The high number of measles cases reported in Europe in 2011 contributed to record numbers of imported cases in the United States.”
Als0, with respect to exemptions, the CDC stated that:
Exemption levels continue to be low overall; however, these low levels are aggregated at the state level before they are reported to CDC. The reported exemptions could be for one or more required vaccines. It is unlikely that children with an exemption were completely unvaccinated. The 2005–2006 birth cohort matriculated into the school system during the 2011–12 school year, and their vaccination coverage was measured using data from the 2006–2009 National Immunization Surveys, which indicate that <1% of children had not received any vaccines. A study of school children with nonmedical exemptions found that 75% of these children had received at least one vaccine previously. The process of requesting an exemption might be related to exemption levels, with easier standards for exemption being associated with higher levels of exemption.
“It is of concern when we have these communities in the United States where there’s enough people who have made this decision [not to vaccinate] that if the measles virus is imported from overseas, that it could actually spread and cause an outbreak,” Dr. Melinda Wharton, the deputy director of the CDC’s National Center for Immunization and Respiratory Diseases, said, according to Reuters.
I think there’s a couple of key items to note. First, there’s reason for optimism because even though the vaccination rate just slightly missed the target of 95% for MMR and varicella, it exceeded it for DTaP, hepatitis B and polio. Second, the exemption rate seems to be flattening, as there seems to be only a small group that buys into the lies and conspiracy theories about vaccines. Of course, the message that vaccines are safe and save lives is being spread by individuals like Paul Offit (Deadly Choices: How the Anti-Vaccine Movement Threatens Us All) and Stacy Mintzer Herlihy and E. Allison Hagood (Your Baby’s Best Shot: Why Vaccines Are Safe and Save Lives).
Third, and probably most important, the vaccination rate is not smoothly distributed across the country–some states exceed the target 95% level on all vaccinations, but some do not. Some, like Colorado and Idaho, have somewhat low vaccination rates (in the mid-80′s). Even in states with good vaccination rates, there are areas with high exemptions and low vaccination rates–one only need look at the current pertussis epidemic in Washington state to see how complex the situation can become. This is why individuals like myself and others continue standing up for the safety and efficacy of vaccines.
Very simply, Vaccines Save Lives. I guess the vast majority of Americans agree, and kids are being vaccinated.
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