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Childhood Vaccination Rates Hit Record High

But many adults aren't getting recommended inoculations, federal officials say

TUESDAY, July 26, 2005 (HealthDay News) -- Record levels of American children are receiving recommended vaccinations against dangerous diseases, but that success isn't being met by adults, according to a new federal report.

An estimated 81 percent of children aged 19 to 35 months received the full series of immunizations last year, according to the 2004 National Immunization Survey, released Tuesday to kick off August as National Immunization Awareness Month.

"For the first time, we have broken the 80 percent coverage barrier for the full immunization series at 2 years of age," Dr. Steve Cochi, acting director of the National Immunization Program at the U.S. Centers for Disease Control and Prevention, said during a news conference. "This is five years ahead of the Healthy People 2010 schedule." In 2003, 79.4 percent of children were fully immunized.

There were also sizable gains in the proportion of young children receiving the relatively new chickenpox and childhood pneumococcal vaccine. In 2004, 87.5 percent of children received the chickenpox (varicella) vaccine, compared with 84.8 percent in 2003. Coverage for three or more doses of pneumoccoccal conjugate vaccine rose to 73.2 percent from 68.1 percent for the same time period.

"We can now protect against 13 diseases that in the past caused great disability, suffering and premature death," Cochi said. "The immunization program in this country is very dynamic, and we can do more than we ever have been able to do in history to protect vulnerable children."

"Measles is no longer endemic in the entire Western Hemisphere as the result of the miracle of measles vaccination, and we have recently been able to announce that we have eliminated rubella and congenital rubella syndrome from the U.S.," he added.

According to the CDC, children should receive the so-called 4:3:1:3:3 series, which includes four doses of diphtheria, tetanus and pertussis (DTaP); three or more doses of polio vaccine; one or more doses of measles-containing vaccine; and three or more doses of Hib vaccine, which can prevent meningitis and pneumonia.

However, there remain great variations in state coverage and in coverage among racial and ethnic groups. Massachusetts had the highest rate of coverage for the 4:3:1:3:3 series (89.1 percent) while Nevada trailed the nation with 68.4 percent. Of the urban areas surveyed, Davidson County, Tenn., had the highest coverage at 89.7 percent, compared with a low of 64.8 percent in El Paso County, Texas.

Among adults, the good news is tempered with more sobering statistics, officials said.

Barely 70 percent of senior citizens are being vaccinated against influenza each year, and only 48 percent of black seniors and 59 percent of Hispanic seniors are receiving their flu shots each year. This is well below the 2010 target of reaching 90 percent of adults 65 years and over.

Even fewer seniors received the pneumococcal vaccine. And only 40 percent of health-care workers, who are highly susceptible to the infection, were immunized.

"This is a public health challenge that we have ignored for too long: making sure adults are protected," David Neumann, executive director of the National Partnership for Immunization, said at the news conference. "We're not meeting the nation's public health targets for protecting adults against vaccine-preventable disease."

Only 56 percent of people on long-term dialysis because of kidney disease have been vaccinated against hepatitis B, while the 2010 target is 90 percent. And only 75 percent of people with occupational exposure to the hepatitis B infection -- such as health-care workers -- are being vaccinated. The goal is for 98 percent of individuals in this category to be immunized by 2010.

"The bottom line seems to be that we lack an appropriate infrastructure to support adult immunization," Neumann said. Creating such an infrastructure, he acknowledged, will take resources.

The somewhat better news is that adolescent immunization rates are improving, although they're still not optimal.

"Currently about 25 percent of adolescents in the U.S. lack at least one of the currently recommended vaccines," Neumann said. Those vaccines include hepatitis B, MMR (measles, mumps, rubella), chicken pox, meningococcal vaccine and pertussis, also known as whooping cough. There are also boosters for teens that strengthen earlier vaccines, such as pertussis, Cochi said.

"Pertussis wears off. We now have a new vaccine that can be used as a booster vaccine for adolescents," he said. "More than half of pertussis cases remaining occur in adolescents."

Sophie Starcevic, 16, who was also present at the news conference, was one of those pertussis statistics. Her diagnosis last spring, said her mother, Monika Burke, "was astonishing. She was 15 and had been vaccinated as a child." It took two visits to the pediatrician before pertussis was even considered and several months for Sophie to fully recover.

Sophie's experience highlights the remaining vaccination challenges, including combating the spread of misinformation, the speakers said. In the United States, some parents continue to fear that thimerosal, a mercury-based preservative once contained in vaccines, can cause autism. And in Nigeria in 2003, rumors that the polio vaccine contained the AIDS virus and/or hormones to sterilize children resulted in thousands of children contracting the crippling disease. This disease has since spread as far away as Indonesia, Cochi said.

"The [vaccination] program is doing very, very well for many children, but we have to sustain it even as vaccine-preventable diseases become a distant memory," Cochi said.

More information

For more on vaccines and vaccine-preventable diseases, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: July 26, 2005, news conference with David A. Neumann, Ph.D., executive director, National Partnership for Immunization; Steve Cochi, M.D., acting director, National Immunization Program, U.S. Centers for Disease Control and Prevention; Monika Burke, mother pertussis survivor Sophie Starcevic
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