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U.S. Teens Fall Short on Vaccine Coverage
Date:8/30/2007

But most younger children are getting their needed shots, federal surveys find

THURSDAY, Aug. 30 (HealthDay News) -- Most young U.S. children are getting their recommended vaccinations, but rates for teens are lagging, especially for some newer vaccines, U.S. health officials announced Thursday.

Last year, 77 percent of children 19 months to 35 months had received their recommended vaccinations. While this is short of the 80 percent goal called for in the federal Healthy People 2010 initiative, it may be close enough to still meet that target in three years, according to the U.S. Centers for Diseases Control and Prevention (CDC).

"That compares with 76.1 percent in 2005," Dr. Melinda Wharton, deputy director of the CDC's National Center for Immunizations and Respiratory Diseases, said during a teleconference. "We continue to have a very high level of vaccination coverage in this age group."

The CDC survey covered six vaccinations for children 19 months to 35 months that protect against 10 diseases. The diseases are diphtheria; tetanus; pertussis (whooping cough); polio; measles; mumps; rubella (German measles); Haemophilus influenzae type b; hepatitis B; and varicella (chickenpox).

Because of the high levels of vaccination, these diseases are present at very low levels in the United States, Wharton said.

Vaccination coverage varied by state and city, Wharton said. The highest level was in Massachusetts with 83.6 percent; the lowest was in Nevada, 59.5 percent. For specific cities, Boston had the highest vaccine coverage at 81.4 percent, and Detroit the lowest at 65.2 percent, according to statistics published in the Aug. 31 issue of the CDC's Morbidity and Mortality Weekly Report.

Vaccination rates are still running behind schedule among minority communities, however, Wharton said. "Children who live below the poverty level are less likely to be vaccinated than children who live at or above the poverty level," she said.

Among white children 19 months to 35 months old, 77 percent received a complete vaccination series, compared with 73.9 percent of black children, Wharton said.

"The Vaccines for Children Program has done a lot over the long run to address the much more marked disparities we used to see back in the 1980s," she said. "But we clearly need to focus on disparity issues."

And greater attention must be paid to teens, Wharton said, noting that the Healthy People 2010 vaccination goals for children 13 to 17 have yet to be met. This is especially true for the vaccines for diphtheria, tetanus, pertussis and chicken pox.

In 2006, teen vaccination coverage was about 80 percent for the new hepatitis B vaccine as well as the vaccine for measles, mumps and rubella. But about 60 percent of teens had gotten the tetanus-diphtheria vaccine or the tetanus-diphtheria-pertussis vaccine, or the varicella vaccine.

Specifically, coverage was 11 percent for the tetanus-diphtheria-pertussis vaccine and 12 percent for the new meningococcal conjugate vaccine, which protects against bacterial meningitis.

Data for the new human papillomavirus (HPV) vaccine, which prevents cervical cancer, were not available for the survey. However, according to Merck & Co., the manufacturer of the vaccine, 7.5 million doses had been distributed in the United States as of June, Wharton said.

"Clearly, we need to get more information to parents and health-care providers and make sure everyone has a good understanding of the recommendations and the health benefits of these vaccines," Wharton said. "It is going to take a lot of work to get the level of coverage among adolescents that we currently have for children," she said.

Dr. David Katz, director of Yale University School of Medicine's Prevention Research Center, said, "Immunization is on the short list of crowning achievements in the history of disease prevention. It is therefore tremendously gratifying that childhood immunization rates are high, rising, and on track to meet Healthy People 2010 goals."

However, vaccines aren't reaching poor children on a reliable basis, Katz said. "This is clear and compelling evidence that financial barriers to health care come at a high cost to society. In this case, children will get diseases we have the means to prevent. That is unconscionable," he said.

Katz also said it isn't surprising that teen vaccination rates lag behind those of younger children. "Young children are more subject to parental control and an easier audience to reach. As new vaccines -- such as Gardasil, the HPV vaccine -- increase the importance of immunizing adolescents, the need for innovative outreach programs to get this group increases," he said.

More information

For more on childhood vaccines, visit the U.S. Centers for Disease Control and Prevention.



SOURCES: David Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Aug. 30, 2007, teleconference with Melinda Wharton, M.D., M.P.H., deputy director, National Center for Immunizations and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta; Aug. 31, 2007, Morbidity and Mortality Weekly Report


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