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While the coverage of a number of vaccines "remains globally high and stable", the unvaccinated segment of children under 2 years of age rose from 0.9% for those born in 2011 to 1.3% for those born in 2015, according to a report. In 2001, only 0.3% of children aged 19 to 35 months had received no dose of vaccine.
"Although the number of children who have not received any vaccinations at the age of 24 months is gradually increasing, most children are still vaccinated in a systematic way," wrote the authors of the National Center for Disease Control. vaccination and respiratory diseases of the CDC. "Continuous assessment of the prevalence and reasons for non-vaccination is needed, as well as improvements in access to vaccination and the administration of age-appropriate vaccines for all. children. "
However, coverage in this age group exceeded 90% for a number of vaccines, including poliovirus, hepatitis B, chickenpox and measles, mumps and rubella.
Those who were least likely to be fully vaccinated: uninsured children and those under Medicaid, compared to children insured privately, although they are eligible for a federally funded program that administers free vaccines. Children out of metropolitan areas were also less likely to be covered than those in larger cities.
"These disparities were greater for vaccines requiring a booster dose in the second year of life," the report says, citing as examples vaccines against diphtheria, tetanus and whooping cough.
Although the report does not identify the reasons for this trend, the authors say it could be related to lack of knowledge about how to access free vaccines. transport; proximity and date of opening of clinics; childcare; and a shortage of pediatricians and other health care providers in rural areas.
Vaccination rates varied by state. Coverage of rotavirus (a common cause of intestinal flu in children) was highest in Rhode Island (85.1%) and lowest in California (64.7%). Coverage for measles, mumps and rubella was highest in the Massachusettes (98.3%) but lowest in the Missouri (85.8%).
The second report focused in part on vaccine exemption rates for kindergarten children. This school year is the third consecutive year to experience a "slight increase" in the overall proportion of children enjoying an exemption, the report says.
"The median percentage of kindergarten children benefiting from an exemption of at least one vaccine was 2.2%," the report says, and the non-medical vaccine exemption rates range from 0.1% in California to 7.5% in Oregon.
The reasons for the exemptions were not included, but could imply "parental hesitancy to the vaccine" and the ease with which an exemption could be obtained in a given state.
Among the states included in the analysis of the preschool (41 or 49 states by vaccine plus Washington DC), the national capital recorded the lowest median rates of vaccine coverage against chickenpox; diphtheria, tetanus and whooping cough; and measles, mumps and rubella. Mississippi had the highest rates.
"During the 2017-18 school year, the median coverage of maternal vaccination was nearly 95% for the MMR vaccine, the Dactic vaccine and the chickenpox vaccine," the authors wrote.
Previous research has shown that some metropolitan areas of "hotspots" also have a high proportion of non-medical exemptions and may therefore be particularly vulnerable to epidemics, including Seattle, Portland and Phoenix. According to researchers, the high number of unvaccinated children living in large cities with busy international airports could contribute to the risk of rapid spread of the disease.
Other research has shown that states with philosophical exemptions have both higher refusal rates and higher rates of illness.
"Clusters of refusal overlap clusters of outbreaks," CNN Saad B. Omer, professor of global health and epidemiology and pediatrics at Emory University told CNN.
However, "it is difficult to obtain a waiver, refusal rates and sickness rates are lower," he said.
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