Vaccine coverage in USA remains high, but refusal has increased

vaccine coverage

Annually, the US Centers for Disease Control and Prevention publishes reports on vaccine coverage in the country. This year, they produced two reports – one describing vaccine coverage for children 19-35 months old, and a second one discussing vaccination coverage for children entering kindergarten.

Although vaccine coverage remains quite high across most vaccines and hasn’t changed much over the past few years, there is a bit of troubling news. A tiny, but increasing number of children in the country are not getting some or all of their recommended vaccines as a result of parental refusal to vaccinate their children. In fact, the percentage of children under 2 years old who have received none of the recommended vaccines has quadrupled since 2001.

Vaccine coverage – 19-35 months old

The first study by Holly A Hill, MD Ph.D. et al., published in the Morbidity and Mortality Weekly Report, examine vaccine coverage for Advisory Committee on Immunization Practices (ACIP) recommended vaccines in children born in 2015.

For some of the vaccines, the vaccination coverage exceeded 90%:

Unfortunately, for some ACIP-recommended vaccines, the coverage lagged:

There are a few key observations about this data. First, despite the false claims about the MMR vaccine being linked to autism, the vaccine coverage for MMR remains at historically high levels. On the other hand, hepatitis B vaccine coverage, especially at birth, is too low, despite that the fact that these vaccines are important for cancer prevention.

Vaccine coverage by state also showed some interesting information – Massachusetts has the highest vaccination rates for children born in 2015 of all states. The City of New York, considered a “state” for the purposes of this study, had the lowest rate.

However, it is troubling that, even though the proportion of children who received no vaccines by age 24 months, it has increased from 0.3% for children born in 2001 to 0.9% for children born in 2011 to 1.3% for children born in 2015. This works out to be over 100,000 children born in 2015 who aren’t vaccinated against 14 dangerous and deadly diseases. This is worrisome.

Although I do not want to give credit to the anti-vaccine religion for causing this troubling increase in vaccine refusal. The internet is filled with ignorant and scientifically inaccurate information about vaccines. Quora, where individuals can ask questions about almost anything, is filled with individuals asking questions about vaccines in good faith. Although 95% of the answers are scientifically and medically accurate, there are many individuals who use misinformation, ignorance, and outright lies to scare people about vaccines.

Eventually, this can lead to the point, where the overall vaccine coverage will drop below the level to maintain the herd effect. At that point, there are insufficient numbers of immunized people to block the spread of an outbreak or epidemic of these vaccine-preventable diseases.

On the other hand, the study points out that part of the lack of vaccination may be a result of an ongoing issue with the USA – the lack of universal health insurance, especially for the poor. This study showed that 17.2% of unvaccinated children were uninsured compared to 2.8% of all children. Looking at the data from another direction, over 7% of uninsured children were unvaccinated compared to only 1.0% of children on Medicaid and 0.8% of children on private health insurance.

This is one of the great moral failings of the country. However, there really are no reasons why any child in the USA is denied vaccines. The Vaccines for Children Program provides free vaccines for all children in the USA who otherwise have no insurance coverage. The program has saved hundreds of thousands of lives over the past 20 years.

Vaccine coverage – kindergartners

A second report, by Jenelle L Mellerson et al. and published in the Morbidity and Mortality Weekly Report, examined vaccine coverage for children entering kindergarten in 2017. The good news is that, despite somewhat lower vaccination rates in states like DC, Idaho, and Colorado, the overall vaccine coverage for the major vaccines is well over 90% for kindergartners.

The researchers found that the exemption rate was low, about 2.2%. Unfortunately, it was the third consecutive school year that a slight increase noted. The 2.2% exemption rate during the 2017-18 school year was up from 2.0% in 2016-17, and 1.9% in 2015-16.

The study does not provide a breakdown between medical (where there is a valid medical reason to not vaccinate a child with one or more vaccines) and non-medical exemptions. The non-medical exemptions, often called “personal belief” exemptions are simply refusing to vaccinate a child because of a variety of reasons – religious (no religion is opposed to vaccines) or because “we don’t like vaccines.” Most exemptions are of the non-medical variety.

Only a few states disallow these personal belief exemptions – California, Mississippi, and West Virginia. Unsurprisingly, California and Mississippi have the lowest non-medical exemption rates in the USA, at less than 0.1%. Unfortunately, California has an issue where unethical physicians are giving out (or even selling) non-medical exemptions for parents who want to put their children in danger of vaccine-preventable diseases.

Summary

These two studies show us two dangerous trends – first, too many very young children are going unvaccinated because of parental ignorance or lack of health insurance. And second, too many parents are putting their children at risk of vaccine-preventable diseases by requesting non-medical exemptions.

However, despite the pseudoscientific lies of the hysterical anti-vaccine religion, nearly 95% of children are vaccinated before they enter school. Unlike the anti-vaccine zealots, who seem to dismiss a few thousand cases of cancer or deaths from measles as unimportant or trivial, most of us on the pro-science side of vaccines want all children protected from dangerous and deadly diseases. That’s why we fight to make sure every single child is vaccinated.

Why aren’t you making sure that your children are protected from vaccine-preventable diseases?

Citations



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Sexual promiscuity and the HPV vaccine – debunking an ignorant myth

sexual promiscuity and the HPV vaccine

There is a myth pushed by the anti-vaccine religion that the HPV vaccine leads to sexual promiscuity. I’ve debunked this fable previously, using peer-reviewed research, but you know the anti-vaccine zombie tropes – they never really die, and they always come back to life.

Let’s look at a couple of new studies that, once again, debunk the myth that sexual promiscuity is linked to the HPV vaccine. There is no link. Period. Full stop. Continue reading “Sexual promiscuity and the HPV vaccine – debunking an ignorant myth”

43,000 HPV-associated cancers annually – HPV vaccine can prevent most

HPV-associated cancers

As I’ve written before, there are just a handful of ways to reduce your risk of cancer. Don’t smoke. Stay out of the sun. Keep a healthy weight. Don’t drink alcohol. And get vaccinated with the HPV vaccine to prevent HPV-associated cancers (see Note 1).

Too many people who discuss the HPV vaccine, especially among the anti-vaccine religion, tend to focus on HPV-related cervical cancer. But HPV is linked to several dangerous and deadly cancers, and a new report examines the details of those cancers.  Continue reading “43,000 HPV-associated cancers annually – HPV vaccine can prevent most”

Former CDC director arrested – hey anti-vaxxers, not relevant to vaccines

Former CDC Director

Last week, former Centers for Disease Control and Prevention director Dr. Thomas Frieden was arrested and charged with groping a woman at his home. The former CDC Director was charged with third-degree sexual abuse, forcible touching, and harassment, the last of which carries a fine but no jail time.

Of course, within a few nanoseconds of the arrest, anti-vaccine quack websites did their best to tie his arrest to some imaginary and nonsensical malfeasance at the CDC. I don’t think any of us were surprised by this kind of attack by the anti-vaccine religion, but just in case someone thinks that what the former CDC Director did AFTER he was in charge of the CDC has something to do with vaccines, I’m here to disabuse anyone of that thought.

First of all, let us remember that Dr. Frieden has been charged but not found guilty of his actions. I know that the world has changed with the MeToo movement, and many of us have a sinking feeling that since he was caught here, there may be many more cases of it that will be uncovered from his past. Despite the current world where we no longer believe in “innocent until proven guilty,” it’s probably important to remember he has not been “proven guilty.”

Secondly, what has this got to do with vaccines? Well, nothing, but the anti-vaxxers love their silly strawman arguments and pseudo-conspiracies, so they will use it as a proxy to “prove” that the CDC is so corrupt that we can’t trust them on vaccines.

In case you weren’t watching, this has happened before when the anti-vaxxers invented a conspiracy when a Danish CDC researcher, Poul Thorsen, who stole about US$1 million from research funds. And that had nothing to do with vaccines.

The anti-vaccine conspiracies about former CDC Director Frieden have nothing to do with vaccines.  Continue reading “Former CDC director arrested – hey anti-vaxxers, not relevant to vaccines”

Vaccines and autism – science says they are unrelated

vaccines and autism

Vaccines and autism are not linked or related according to real science, published in real scientific journals written by top scientists and physicians.

But this false claim is in the news again. Probably as a result of reports that more and more children are being diagnosed with autism spectrum disorders. So let’s take a look at the science.

On 26 April 2018, the United States Centers for Disease Control and Prevention (CDC) announced that new data showed a continued rise in the number of children diagnosed with autism spectrum disorder (ASD). ASD is considered to be a disorder of neural development, usually appearing before the age of 3 years, characterized by impaired social interaction and verbal and non-verbal communication, and by restricted, repetitive or stereotyped behavior.

Predictably, the anti-vaccine community jumped on this information (despite their hatred of the CDC) to make unfounded claims, not backed by science, that this was all the fault of vaccines. Of course.

Continue reading “Vaccines and autism – science says they are unrelated”

CDC updated autism statistics – not an epidemic, not caused by vaccines

CDC updates autism statistics

On 27 April 2018, the Centers for Disease Control and Prevention (CDC) released new statistics on autism incidence in the USA – the CDC estimated that 1 out of every 59 children has been diagnosed with autism spectrum disorder (ASD) in 2014. This is a fairly large increase over the 2002 numbers when the CDC estimated that 1 in 152 children was diagnosed with ASD. Just because the CDC updated autism statistics does not mean that there’s suddenly an autism epidemic, nor that vaccines are to blame.

Predictably, the anti-vaccine mob was resorting to their full-throated screaming mode about these new stats. And of course, even if you are a dispassionate observer of these numbers, you may wonder why the autism diagnosis rate has nearly tripled from 2002 to 2014.

And that’s why we’re here – let’s examine why and how the CDC updated autism statistics. And I’m going to show you why it’s not a sudden epidemic – it’s better scientific research. Continue reading “CDC updated autism statistics – not an epidemic, not caused by vaccines”

Polio vaccine causes cancer – a myth pushed by anti-vaccine religion

polio vaccine causes cancer

Apparently, the “polio vaccine causes cancer” zombie meme has been reanimated by the antivaccination cult. Lacking evidence for their beliefs, retreading old debunked memes is their standard operating procedure. And once again, I’m seeing it.

The interesting thing about social media (Facebook, Twitter, blogs, Google, Reddit) is that it’s fairly easy to push pseudoscientific beliefs. The first problem is that many people read the headlines, and never the underlying discussion. If it can be said in 200 characters, or a misleading infographic, many individuals will share that across the internet as a “fact”. So, if you see a claim that “Polio vaccines infected 98 million Americans with a cancer virus,” many people will immediately see that an accept it without much criticism.

Of course, this leads to a second problem. To refute anti-vaccine claims take a lot more than 200 characters. The refutation is often complex, nuanced and highly scientific, and may take 2000 words or more to send that claim into orbit. It’s highly emotional to claim a vaccine can cause cancer. On the other hand, to say it is not isn’t emotional–it’s coldly logical. And takes a lot of words.

And the third problem is that is that social media fallacies have multiple lives, so when someone reads one of these memes a year from now, they think “yeah, this is great information”, and pass it along as if it’s the Truth™. Killing zombie anti-vaccine tropes and memes are just as difficult as killing zombies in real life, or at least, on a TV show. Debunking these anti-vaccine fake facts is a full-time job. Sadly, even after a thorough debunking, someone will call us a paid shill, ignore the evidence, and repeat the trope.

I need to create a bot that automatically refutes every repeated trope. In lieu of that, let’s just discuss the myth. And refute it once again.

Continue reading “Polio vaccine causes cancer – a myth pushed by anti-vaccine religion”

Once more about Andrew Wakefield fraud extraordinaire

For the handful of you who don’t know him, MrAndrew Wakefield fraudulently alleged a connection between the MMR vaccine, for measles, mumps and rubella) and autism – this has had the effect of suppressing vaccination rates in many countries. His claims were published in a now retracted paper published in the Lancet, a mostly respected medical journal who seemed to have forgotten how to do proper peer review back in the late 1990’s. This is a quick review of the Andrew Wakefield fraud.

Dorit Rubinstein Reiss – Professor of Law at the University of California Hastings College of the Law (San Francisco, CA) – is a frequent contributor to this blog. She had posted an article that debunks the myth that Andrew Wakefield is probably innocent of all charges made against him by the UK’s General Medical Council (GMC). Basically, some of the antivaccination crowd believes that because Wakefield’s partner in the fraud, Professor John Walker-Smith, had his own decision by the GMC overturned, it is considered evidence that Andrew Wakefield was wronged when the GMC found Wakefield, too, guilty of serious ethical violations. But that would be an incorrect interpretation of the facts. Continue reading “Once more about Andrew Wakefield fraud extraordinaire”

Robert Redfield named CDC director – what does this mean for vaccines?

robert redfield

The Centers for Disease Control and Prevention (CDC) is America’s national public health institute – it is one of the most respected scientific institutions in the world. And the CDC Director, a presidentially appointed position, usually sets policy for public health in the USA, while they have considerable influence over public health worldwide. After the resignation of Dr. Brenda Fitzgerald in January 2018, President Donald Trump appointed Dr. Robert Redfield as the new CDC Director.

Despite the fantasies of the anti-vaccine religion and other science deniers, the CDC is staffed by highly educated and trained scientists, public health experts, physicians, and nurses, many of them are officers in the United States Public Health Service. These people are dedicated to the public health of Americans and often spend their lives keep all of us safe from harm from diseases.

The CDC’s main goal is to protect public health and safety through the prevention of disease, injury, and disability not only in the USA but also internationally. The CDC is an independent Federal agency whose dedicated staff stand at the front lines of infectious diseases throughout the world. The agency also focuses on non-infectious diseases, such as diabetes and obesity. Finally, they provide educational activities designed to improve health.

Of course, the CDC matters to me because they are the primary source of information about vaccines and vaccine-preventable diseases in the USA and the world. Though the CDC does not control vaccinations, they only set recommendations that states and certain parts of the Federal government (like the military and foreign service officers) generally follow. The CDC follows logical and scientific procedures to make these recommendations.

And now we have a new CDC Director, Dr. Robert Redfield, who at first blush appears to be a reasonable choice for the position. However, I am a scientific skeptic, so I never stop at the first blush. Continue reading “Robert Redfield named CDC director – what does this mean for vaccines?”

Mumps vaccine effectiveness – waning immunity may require 3rd dose

mumps vaccine

Over the past few years, there has been a resurgence in mumps outbreaks across the USA and other parts of the world. Although these outbreaks did not spread widely as they did before the advent of mumps vaccines, it still required some scientific research into why this happened. According to just published peer-reviewed research, much of the mumps outbreaks may result from waning mumps vaccine effectiveness.

Because I am concerned that this new article will be misinterpreted by some parts of the discussion, I’m glaring at the anti-vaccine religion, it is important that we take a very careful look at this well-done study examining what could be the root cause of some outbreaks – waning immunity to the mumps vaccine. Continue reading “Mumps vaccine effectiveness – waning immunity may require 3rd dose”