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In the United States, a small but growing number of children are not receiving all or some of the recommended vaccines. The number of children under 2 years of age who have received no vaccine has quadrupled in the last 17 years, according to federal health data released Thursday.
Overall, vaccination rates remain high and have not changed much at the national level. But two reports by the Centers for Disease Control and Prevention on vaccination of preschool and preschool children reveal growing concern among health officials and clinicians about children not receiving the necessary protection against vaccine-preventable diseases, such as measles, whooping cough and other pediatric infectious diseases.
The vast majority of parents across the country vaccinate their children and adhere to the recommended calendars for this basic preventive practice. But the recent rise of skepticism about vaccines and the categorical refusal to vaccinate have led to communities of under-vaccinated children more exposed to the disease and presenting risks to the health of the general public.
Of the children born in 2015, 1.3% had not received any of the recommended vaccines, according to the CDC analysis of a 2017 national immunization survey. This was compared to 0.9 % in 2011 and to 0.3% of children aged 19 to 35 months who were not vaccinated during the survey conducted in 2001. Assuming that the same proportion of children born in 2016 has not been vaccinated, about 100,000 children who are now under 2 years old are not vaccinated against 14 potentially serious diseases, said Amanda Cohn, Pediatrician and CDC's Senior Vaccine Advisor. Although this figure represents only a tiny fraction of the 8 million children born in the last two years who have been vaccinated, the trend is worrying officials.
"It's something that really concerns us," Cohn said. "We know that some parents choose not to vaccinate their children, and some parents may want and be unable to vaccinate their children.
Some diseases, such as measles, have returned to the United States because parents in some areas have failed or chose not to vaccinate their children. Last year, Minnesota was hit by a measles epidemic, the state's worst in decades. This was triggered by anti-vaccine activists who targeted an immigrant community, spreading misinformation about the measles vaccine. Most of the 75 confirmed cases were young Americans of unvaccinated Somali origin.
The data underlying the latest reports do not explain the reason for the increase in the number of unvaccinated children. In some cases, parents hesitate or refuse to vaccinate, officials and experts said. Insurance coverage and the disparity between urban and rural areas are probably the other reasons for this worrying increase.
About 2% of children aged 19 to 35 months living in rural areas were not vaccinated in 2017. This is double the number of unvaccinated children living in urban areas.
The new data shows that health insurance also plays an important role. About 7% of uninsured children in this age group were not vaccinated in 2017, compared with 0.8% of privately insured children and 1% of those covered by Medicaid.
These differences are of concern because uninsured children and those insured by Medicaid are eligible for free vaccinations under the federally funded Vaccines for Children program.
"Parents may not be aware of this, so it may be an educational problem," Cohn said.
Other problems, such as child care, transportation and shortage of pediatricians in rural areas, are also likely to affect immunization coverage.
A second report on immunization coverage of children entering kindergarten in 2017 also showed a gradual increase in the percentage of people exempted from immunization requirements. (The exemptions do not distinguish between a vaccine and all vaccines.)
Eighteen states allow parents to exclude their children from vaccination requirements for non-medical reasons, with exemptions for religious or philosophical beliefs.
The overall percentage of children benefiting from an exemption was low at 2.2%. But the report noted "it's the third consecutive academic year that a slight increase has been observed". The report does not provide a breakdown, but the majority of exemptions are non-medical, according to data provided by the states.
Saad Omer, professor of global health, epidemiology and pediatrics at Emory University, said that an analysis he had conducted with his colleagues a few years ago had revealed that the rate of increase in non-medical exemptions seemed to be stabilizing by 2015-2016, year after year. d & # 39; increase.
But the latest data from the CDC seems to reflect a change, he said. "It seems that in recent years, the exemptions are increasing and that the trend is probably due to the refusal of parents to be vaccinated," he said.
During the 2017-2018 school year, 2.2% of American children in kindergarten were exempted from one or more vaccines, up 2% from the 2016 school year -2017 and 1.9% compared to the 2015-2016 school year, according to the CDC report. .
The reasons for this increase could not be determined from the data provided to the CDC, the agency said. But researchers said the factors could include ease of obtaining exemptions or hesitation or refusal of parents to vaccinate.
States like West Virginia and Mississippi, which do not allow exemptions from non-medical vaccines, are recording higher percentages of vaccinated children, said Mobeen Rathore, an infectious disease physician at the Ministry of Health. child in Jacksonville, Florida. and a spokesperson for the American Academy of Pediatrics AAP.
Earlier this year, researchers at several Texas academic centers identified "hotspots" where the risk of an epidemic is rising in 12 of the 18 states that allow non-medical exemptions as a growing number of mothers have not been vaccinated.
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