Routine Childhood Immunization Can Prevent Resurgence of Once-Common Diseases

By Elizabeth K. Cherot, MD, MBA, Senior Vice President and Chief Medical and Health Officer, March of Dimes

The recent measles outbreak among unvaccinated children in Ohio, as well as the polio outbreak in New York, reveal how some potentially disabling and fatal vaccine-preventable diseases are making an unfortunate comeback. These alarming trends highlight the critical importance of improving access to vaccines and adherence to the CDC-recommended vaccination schedule. In partnership with Pfizer, we surveyed parents with children last year who are uninsured or covered by Medicaid to learn more about barriers to vaccination and further understand the “why” behind the lagging immunization rates. 

According to the latest data by the Centers for Disease Control and Prevention (CDC) an estimated 70.1 percent of children born in 2018-2019 were up to date on all of the seven-vaccine series recommended to help prevent diseases like measles, polio, whooping cough, and invasive pneumococcal disease by age 24 months. But there are persistent disparities in vaccination coverage due to health insurance status, race and ethnicity, and poverty status. 

Less than half (45.2%) of children with no insurance received the recommended seven-vaccine series and Hispanic children (69.1%) and Black children (62.7%) were the least likely to be fully immunized. Just 59.5% of children living below poverty had received the recommended seven-vaccine series. To make matters worse, rates for childhood vaccines fell further due to the pandemic. 

In our survey, we found lack of awareness about the availability of free vaccines and vaccine recommendations were significant barriers for parents. Based on income and Medicaid eligibility, it is likely that all survey respondents have children who are eligible for free vaccines through the Vaccines for Children (VFC) program. Yet, only 21% had heard of the program and just 10% had used it to get vaccines for their children. Lack of knowledge (29%) about recommended vaccines played a role in decision making with more than a third (37%) of parents surveyed saying they are not worried about the specific diseases the vaccines help prevent.

We also heard about access barriers that impacted parents’ ability to get their children vaccinated: 35% said not having a regular doctor was a factor, 33% said lack of insurance coverage was a factor, and 27% reported that lack of access to transportation was a factor. 

Among parents who said their youngest child had not received any of the recommended vaccines, we found that trust is a critical factor: 70% said concerns about the safety of vaccines influenced their decisions. 

Based on these data, it is clear we need to do more to educate parents around the safety and importance of vaccinations and to help close the equity gap in childhood vaccinations. We are proud that March of Dimes is a trusted source for health information, and we are working to ensure that conversations about vaccines are happening at the grassroots level among friends and family and in the broader community by providing our vast network of moms, community leaders, healthcare providers and organizational partners with information about the safety and efficacy of vaccines.   

Our advocacy efforts on health equity can also help close the gap. We support bipartisan legislation in both the House and Senate to expand and enhance the VFC Program. H.R. 2347 and S. 2691 would expand the VFC program to include children enrolled in the Children’s Health Insurance Program (CHIP) and provide for additional payments to incentivize provider participation. Importantly, the legislation also expands coverage under Medicaid and CHIP to include vaccine counseling and educational services for children.

With the COVID-19 pandemic, we saw the global devastation that infectious disease can have on our families and communities. Because vaccines have kept diseases like polio and measles at bay for a generation, many of us witnessed this devastation for the first time. The gap in routine childhood immunization coverage should alarm all of us, and serve as a call-to-action to use our collective resources to give parents the knowledge, trust and access they need to help keep their children healthy.