While most 2-year-olds have received at least some vaccines, the rate of unvaccinated
young children has been rising, according to a new report from federal health officials.
“While we know parental choice clearly plays a role, we also see in this report that
access does seem to be an issue,” said Amanda Cohn, M.D., FAAP, senior advisor for
vaccines for the Centers for Disease Control and Prevention’s (CDC’s) National Center
for Immunization and Respiratory Diseases. “In particular, uninsured kids were highly
represented in that group of kids who didn’t get vaccinated.”
Data from the 2017 National Immunization Survey-Child on toddlers show coverage rates
were over 90% for multiple vaccines — at least three doses of poliovirus vaccine,
at least one dose of measles, mumps and rubella vaccine (MMR), at least three doses
of hepatitis B vaccine and at least one dose of varicella vaccine. Vaccine coverage
was lowest for hepatitis A, the seven-vaccine series, rotavirus and hepatitis B.
Roughly 1.3% had not received any vaccinations by 24 months, according to the report.
That’s up from 0.3% in the 2001 survey.
Coverage rates were lowest for children who were uninsured and those in rural areas.
Among unvaccinated children, about 17.2% were uninsured compared to 2.8% of all children,
according to the report.
Transportation, availability of doctors and clinic hours all may be barriers to vaccination.
The CDC is working to increase awareness of the Vaccines for Children program, which
provides free vaccines to eligible children who are unable to pay. Dr. Cohn said pediatricians
can help by referring uninsured patients to participating providers. They also should
vaccinate children in rural areas on schedule at every opportunity as these children
may not get into the office frequently.
She credited health care providers for the high overall rates and encouraged them
to continue to educate families.
“Their strong recommendation for children in their practice to get vaccinated is incredibly
influential on a parents’ choice to get vaccinated, so just reiterating the importance
of vaccination and helping parents understand the benefits of vaccination and the
severity of diseases they are preventing is really important,” Dr. Cohn said.
A second CDC report found high overall vaccination rates among kindergartners but
also room for improvement.
For state-required doses of diphtheria, tetanus and acellular pertussis (DTaP) vaccines,
median coverage was 95.1%, according to data collected by state and local vaccination
programs. Similarly, median coverage was 94.3% for two doses of MMR vaccine and 93.8%
for two doses of varicella vaccine. For all three vaccines, Mississippi had the highest
coverage rates while Washington, D.C., had the lowest.
A median of 2.2% of kindergartners had an exemption from school vaccination requirements,
increasing slightly for the third consecutive year. Dr. Cohn said the increase may
be due in part to improved reporting that classifies children as having an exemption
rather than being provisionally enrolled.
Exemptions ranged from 0.1% in Mississippi to 7.6% in Oregon, and most were nonmedical.
A median of 1.8% of kindergarten students were provisionally enrolled or attending
school during a grace period.