State: Child immunization rates up, but more to be done

Vaccine coverage among Minnesota toddlers remained largely unchanged last year, with a few exceptions.

A new survey by the Centers for Disease Control and Prevention shows the number of children receiving three newer vaccines increased in 2010 over the previous year. The immunization rate declined for only one vaccine, partly due to a temporary shortage.

While the report shows some positive trends, state Department of Health officials say the overall vaccine picture is not as rosy as it might appear.

The CDC report focuses on vaccines given during the first years of life, between 19 and 35 months of age. Recommended immunizations range from newer vaccines that prevent chickenpox and rotavirus, both produced during the last two decades, to long-standing immunizations that protect against polio, measles and diptheria.

In Minnesota, early childhood immunization rates hover around 90 percent for many of the older vaccines.

But immunization rates for newer vaccines such as Hib — short for Haemophilus influenzae type B — are way too low, said Kris Ehresmann, an epidemiologist with the department. Before the Hib vaccine was introduced in the 1980s, the bacteria once killed thousands of babies and toddlers every year in the United States.

"For instance we've seen a 13 percent increase for the Haemopholis influenzae vaccine. We're still at 63 percent," Ehresmann said. "Well that's great that we've seen improvement, but we haven't reached the 90 percent that we'd like to see."

Such gaps in coverage have hurt the state's overall immunization rate for toddlers. The CDC survey estimates that roughly 75 percent of Minnesota toddlers are fully immunized.

Ensuring that their children receive the vaccines is a priority for many parents. London Amos, of Minneapolis, said there was never any doubt about whether she would immunize her daughter.

Three-year-old Jayla Amos received the last of her toddler vaccinations Wednesday. She's a few months past the recommended window, but she got her immunizations in time for the start of preschool this month.

"Personally I've been getting immunizations ever since I was young," Amos said. "I just think it's a good thing just to keep her healthy and other kids around her healthy."

At the Minneapolis clinic, where Amos took her daughter, doctors are busy trying to cram in last-minute appointments for children who need immunizations to attend school.

But the flurry of immunization activity right before school is a little deceptive, said Dr. Sheldon Berkowitz, medical director of the General Pediatrics Clinic at Children's Hospitals and Clinics of Minnesota.

"We're struggling like lots of places in the country to keep our immunization rates up," Berkowitz said. "They're not as high as anybody would like, they're drifting down, and we're struggling to find answers to why people aren't immunizing."

In Minnesota, parents are required to prove their children have received their vaccinations before starting kindergarten, and again in junior high school. Parents can opt out, but they have to sign a form indicating they object to the immunizations.

Most Minnesota parents do eventually make sure their children have the required vaccinations. But the state's expanded vaccine schedule has made it challenging for some parents to squeeze them all in by age 3. Periodic vaccine shortages also make it hard for parents to keep up with the schedule.

Several factors could be affecting the state's immunization rates. The vaccine schedule has expanded in recent years, making it challenging for some parents to squeeze in all of their child's immunizations. Periodic vaccine shortages also make it hard for parents to keep up with the schedule.

But health officials are most concerned about what they see as a small, but growing resistance to vaccines due to safety fears.

Carol Race, of Eagle Bend, Minn., stopped vaccinating her children after researching possible explanations for her sons' disorders. Race's oldest boy has Asperger's syndrome. Her other son is severely autistic.

Race, 49, believes that vaccines caused their conditions. She said there's nothing that public health officials can say that would convince her otherwise.

"When we see the evidence in front of our own eyes we should ignore that and listen to some public official?" Race asked. "I have seen what it did to my kids; I don't need any more evidence."

Last month the independent Institute of Medicine released a report analyzing the safety of vaccines that found no association between immunization and autism. The report did find some health problems associated with vaccines, though is panel of experts said those problems are generally minor and rare.

While a lot of interest has been focused on parents who do not vaccinate their children, the CDC's national survey suggests the practice is not widespread. The report found that less than 1 percent of U.S. toddlers had received no vaccines at all.

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