More Privately-Insured Parents Are Delaying or Opting Out of Vaccinations for Children, Putting Kids at Risk
MINNEAPOLIS/ST. PAUL, March 8, 2011 /PRNewswire/ -- Minnesota has long been known as a leader in the area of childhood vaccination rates, but a new report released today from Children's Hospitals and Clinics of Minnesota shows the state's vaccination rates are backsliding. According to the 2009 National Immunization Survey (NIS), Minnesota has dropped 13 spots in two years – from seventh place in 2007 to 20th place in 2009 – for vaccination coverage rates for the primary series of shots(1) among all children 19 months through 35 months of age.
The decline is part of a worrisome trend that could pose a threat to the health of Minnesota children. The 2009 NIS indicates that in only two years, Minnesota's childhood immunization rate slipped to 76.9 percent in 2009 from 80.5 percent in 2007.(2) Based on the state's current population of 423,000 children ages 0 through 5 years, for every percentage point drop in the immunization rate, 4,230 young kids are exposed to vaccine-preventable disease.(3)
"This report serves as an alert to parents and pediatricians, reminding us that we must remain vigilant when it comes to the health of our children," said Alan L. Goldbloom, MD, President and CEO of Children's Hospitals and Clinics of Minnesota.
Adolescent immunization is lagging. Minnesota ranks poorly against other states for vaccination rates for its adolescents, according to the 2009 NIS. The vaccination rate for tetanus, diphtheria and pertussis (Tdap) among 11- to-12-year-olds is 52 percent, which is below the national rate of 55.6 percent and ranks 35th among the states. Minnesota's immunization rate for meningococcal conjugate (MCV4) – a serious bacterial illness that is the leading cause of bacterial meningitis in children – is 43.9 percent, which is below the national rate of 53.6 percent and puts Minnesota 38th in the nation.
Parents are wary of new vaccines. State public health officials have noted that Minnesota parents are slow to accept newer pediatric recommendations, such as the hepatitis B birth dose. Since 2005, it has been recommended that all infants be vaccinated against hepatitis B before release from the hospital.(4) Yet only one in six Minnesota hospitals administers the vaccine at birth.(5) Minnesota's hepatitis B birth dose immunization rate is 34.1 percent – far below the national average of 60.8 percent, according to the 2009 NIS.
Complacency about vaccine-preventable disease. Myths and misconceptions about vaccinations – in addition to the fact that some parents and health care providers have never seen the devastating effects of vaccine-preventable disease – have led many parents to be complacent about vaccination. This may help explain the recent State of Health Care Quality Report finding that national vaccination rates dropped among children on private insurance plans, while they were up slightly for children on public plans.(6)
In Minnesota, 1,000 cases of whooping cough (pertussis) were reported in the state in 2010.(7) Although California received more attention because of the 10 infant deaths attributed to whooping cough in 2010, Minnesota actually had a higher incidence per capita over the same period. As noted earlier, Minnesota has adolescent Tdap immunization rates below the national average.
The Special Case of Influenza Immunization
Although Minnesota is above the national average when it comes to influenza vaccine among children, inadequate Medicaid reimbursements to physicians are putting vaccination rates in danger. The reimbursement rate is particularly low in Minnesota, where the Medicaid reimbursement rate of $8.50 in 2007 is 28th place among states for vaccine administration and is about $6 less than the federally recommended rate. A new report shows that influenza vaccination rates among poor children would rise if Medicaid increased what it pays doctors for giving the influenza vaccine.(8)
Recommendations to Improve Vaccination Rates
While immunization issues are complex, Children's Hospitals and Clinics of Minnesota has outlined several ways to get Minnesota back on track.
- Immunization registries. All clinics in Minnesota should use MIIC, the Minnesota Immunization Information Connection, so that there is a centralized repository of information to help health care providers keep track of a child's immunization history, especially when they change clinics.
- Increase "up-to-date" immunization status for all Minnesota children. This would entail promoting on-time vaccination through the immunization schedule, making sure parents bring children in for well-child exams and vaccinations and reminding providers to reduce "missed opportunities" to vaccinate.
- Enhance communication with parents and providers. Better communications with patients and providers about the importance of vaccines will go a long way to dispel myths and misconceptions about their dangers. We must help prepare our pediatricians to bring up and answer concerns about vaccines.
The full report can be found at www.childrensmn.org/checkups.
About Children's Hospitals and Clinics of Minnesota
Serving as Minnesota's children's hospital since 1924, Children's Hospitals and Clinics of Minnesota is the seventh-largest pediatric health care organization in the United States, with 332 staffed beds at its two hospitals in St. Paul and Minneapolis. An independent, not-for-profit health care system, Children's of Minnesota provides care through more than 14,000 inpatient visits and more than 200,000 emergency room and other outpatient visits every year. Children's is the only Minnesota hospital system to provide comprehensive care exclusively to children.
(1) 4 DTap, 3 polio, 1 MMR, 3 Hib, 3 Hep B, 1 varicella; abbreviated as 4:3:1:3:3:1.
(2) Centers for Disease Control and Prevention (CDC). 2009 National Immunization Survey: Vaccination coverage among children 19-35 months of age. http://www.cdc.gov/vaccines/stats-surv/nis/data/tables_2009.htm#overall.
(3) Exhibit 1.1, University of Minnesota SHADAC Chartbook, American Community Survey, 2008.
(4) Recommended Immunization Schedules for Persons Aged 1 through 18 Years, U.S. 2010. Morbidity and Mortality Weekly Report (MMWR). January 8, 2010. (5) Minnesota Department of Health.
(6) Issued by the National Committee for Quality Assurance, October 2010.
(7) Minnesota Department of Health, Pertussis Disease Statistics 2010.
(8) Yoo, BK, et al. Association between Medicaid reimbursement and child influenza vaccination rates. Pediatrics. 2010 Nov; 126(5):e998-1010.
SOURCE Children's Hospitals and Clinics of Minnesota