Reviews | Covid isn’t the only reason child vaccination rates are falling

On the other hand, Colorado and Maryland, consistently ranked among the states with the best health systems, reported childhood immunization rates at or around 90% for the 2020-21 school year. most recent year for which CDC data for all states is available. . Colorado’s measles-mumps-rubella rate was 90.5% and Maryland’s was 87.6%, both in the bottom quartile of states.

Surprisingly, perhaps, the nation’s capital’s childhood immunization rate is a dismal 78.9% for measles, mumps and rubella, dangerously below the point at which the spread of the virus will begin to decline, and the rate vaccination against poliomyelitis is 80%. , essentially identical to the herd immunity threshold of the disease.

Covid vaccine acceptance and anti-vax attitudes do not fully explain the differences between states. Neither red-blue partisan affiliations nor the strength of a state’s public health system. Instead, the decline is rooted in longstanding policies in some states that allow, for example, non-medical exemptions, failures to strictly enforce vaccination requirements and inadequate public health campaigns.

Here’s how the decline can be reversed.

States should eliminate non-medical exemptions. Five of the six states that ban these exemptions were well above the national average for vaccination rates in the 2020-21 school year. (The sixth, West Virginia, has not reported its vaccination rates in the last year on record.) The impact of banning non-medical exemptions is well documented. After a 2014-15 measles outbreak that began at Disneyland, the California Legislature and Governor approved a law that effectively eliminated non-medical exemptions.

The result: a 3.3 percentage point increase in the measles-mumps-rubella vaccination rate, putting the state above the measles immunity threshold. In contrast, Idaho, Arizona, Oregon and Wisconsin had the highest exemption rates in 2020-2021, and each had vaccination rates below the national average for measles, mumps and rubella and for diphtheria, tetanus and whooping cough.

States should also end extensions for school children to complete routine vaccinations during the pandemic and undertake vigorous community outreach and education campaigns to encourage vaccinations highlighting their safety and importance. With the pandemic and staffing shortages, many schools have had less time to complete vaccination assessments or contact parents about missing documents. States must provide the necessary resources to ensure compliance.

Children 14 years of age or older should be allowed to obtain all missed childhood vaccines against poliomyelitis, measles and other recommended vaccines without parental permission. In many states, there are precedents for adolescent consent to treatment for sexually transmitted diseases and psychiatric care.