Health and Family

Immunization

Immunization

Immunizations are a vital tool for community health, a line of defense against some of the most deadly and debilitating diseases known. It is particularly important to vaccinate small children, because they are both more vulnerable and contribute greatly to the spread of disease.

Virginia's vaccination rate for children has slipped in recent years from 84 to 80 percent. The state is fighting back, mandating vaccinations for students entering both kindergarten and college, and by putting Healthy Virginians and the federal Healthy People programs in place.  However, immunization rates for adults 65 and older have increased, keeping potentially deadly illnesses under better control in our senior populations.

Why is This Important?

Immunizations work by mobilizing the body's natural defenses against disease. They can prevent disability and death from certain diseases and can help control the spread of infections within communities. Vaccines now control diseases that once spread quickly and killed thousands.

Vaccines are given early in life because many vaccine-preventable diseases are more common and more deadly among infants and small children. Childhood immunization is also an important step in maintaining high community vaccination levels, which prevent outbreaks of such diseases. Adult immunizations are equally key. Some adults were never immunized as children and need to catch up; others need updated vaccines for diseases (e.g., influenza) that mutate over time, rendering older vaccinations ineffective.

How is Virginia Doing?

Children

Successful child immunization is defined by the percent of children ages 19 to 35 months who have received:

• four or more doses of DTP
• three or more doses of poliovirus vaccine
• one or more doses of measles-containing vaccine
• three or more doses of HIB
• three or more doses of HepB vaccine.

Virginia's 2007 childhood immunization rate of 79.6 percent is a significant increase from 1995, when coverage was only 52.8 percent. However, the rate in 2005 was 85.8 percent. This decline moved Virginia from fifth best in the nation in 2005 to 30th in 2007.  New Hampshire had the highest rate at 93.2 percent.  Virginia has a lower immunization rate than Maryland at 92.4 percent, Tennessee at 80.6, and North Carolina at 80.0. The national immunization rate stood at 80.1 percent.

Adults

Data from the Behavioral Risk Factor Surveillance Survey (BRFSS) and also reported by Virginia's Department of Health clearly shows that influenza and pneumococcal vaccination rates in adults age 65 years and older are improving.  Influenza vaccinations  jumped from 65 percent in 2002 to 75 percent in 2008.  Pneumonia vaccinations increased nearly as much -- from 60 percent in 2002 to almost 70 percent in 2008.

What Influences the Immunization Rate?

Several factors influence immunization rates.

Poverty/access to care issues:  Fragmented health care systems, insurance coverage restrictions, provider unwillingness to deliver vaccines in-office, incomplete availability of vaccine for children program services and referral to other agencies for vaccine delivery.

Cultural approaches to health care:  New and widely reported fears of harmful effects from immunizations, low family prioritization for vaccine delivery, misunderstanding of vaccine relevance and lack of trust in the medical community.

Missed opportunities:  Provider manufacturer obstacles, vaccine not available, vaccine shortage (manufacturer), reimbursement deficiencies, lack of simultaneous administration, invalid contraindications, and misinformation about vaccine needs.

What is the State's Role?

The Healthy Virginians' 2010 goal is to reduce the number of cases of vaccine-preventable diseases. Virginia is working to:

• ensure that 2-year-olds are appropriately vaccinated
• increase the number of adults who get annual flu and pneumococcal vaccinations
• help achieve the World Health Organization's goal of global polio eradication
• reduce the cumulative global measles-related mortality rate
• improve vaccine safety surveillance.

Virginia is also  working with the federal government's Healthy People 2010 initiative, whose goal is for 90 percent of children aged 19-35 months to be immunized against DTP, polio, MMR, HIB, hepatitis B and varicella.

The Commonwealth requires all children entering kindergarten to be vaccinated. Local health departments administer vaccinations and Medicaid assists with vaccination payments. Before beginning college in Virginia, all entering freshman must provide up-to-date shot records and have the meningitis vaccination or sign a waiver of refusal.  The Department of Aging helps seniors get vaccinated, as they are particularly vulnerable to serious complications from the flu virus.