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Childhood vaccination rates, a rare health bright spot in struggling states, are declining.

Childhood vaccination rates, a rare health bright spot in struggling states, are declining.

 


Jen Fisher can only do so much to protect her son from the types of infections they might encounter at school. The rest is up to other students and parents in her hometown of Franklin, Tennessee, she said.

Fisher's son Laurie, 12, has a congenital heart disease and has a weakened immune system. To protect herself, Laurie received all the vaccines recommended for children her age. But even if he's vaccinated, the virus, which may just ignore other children, could make him sick and end up in the emergency room, Fisher said.

“We want everyone to get vaccinated so that diseases like measles and diseases that have basically been eradicated don't come back,” Fisher said. “They can certainly have a very negative impact on Raleigh.”

For most of Laurie's life, Fisher could take comfort in Tennessee's high childhood vaccination rates. Tennessee is a public health bright spot in a conservative state with poor health outcomes and the lowest life expectancy in the nation.

Mississippi and West Virginia, similarly conservative states with poor health and low life expectancy, have among the highest vaccination rates for kindergarteners in the nation, a seeming contradiction. However, this stems from the fact that childhood vaccination requirements are not always consistent. James Colgrove, a Columbia University professor who studies factors that influence public health, pointed to other characteristics of the state.

“State policies don't map neatly into 'red' and 'blue' or regionally,” Colgrove said.

Advocates, doctors, public health officials and researchers are concerned that this public health bright spot is fading in some states. Many states have recently reported an increase in the number of people refusing to vaccinate their children as Americans' views change.

The percentage of kindergartners exempt from at least one vaccination during the 2023-24 school year will rise to 3.3%, a record high, and 40 states and Washington, D.C., will receive an exemption from one or more vaccines, according to data from the Centers for Disease Control and Prevention. increased. Tennessee and Mississippi were also among the areas with increases. Nearly all exemptions nationwide were for non-medical reasons.

Vaccine advocates worry that anti-vaccine messages could accelerate the expansion of the “health freedom” movement that has been promoted by leaders in states such as Florida. Anti-vaccine momentum is likely to continue to grow with Donald Trump's election as president and his proposal to nominate anti-vaccine activist Robert F. Kennedy Jr. as Secretary of Health and Human Services.

Pediatricians in states with high exemption rates, such as Florida and Georgia, are concerned that lower immunization levels for kindergarteners could lead to a resurgence of vaccine-preventable diseases such as measles. He said there was. The Florida Department of Health reported non-medical exemption rates for children as high as 50% in some areas.

“The religious exemption is huge,” said Brandon Chatani, a pediatric infectious disease doctor in Orlando. “This makes it easier for these children to enter school without vaccines.”

In many states, religious exemptions are easier to obtain than medical exemptions, which require a doctor's approval.

Over the past decade, California, Connecticut, Maine, and New York have removed religious and philosophical exemptions from their school vaccination requirements. West Virginia didn't have them.

The states with the highest waiver rates for the 2023-24 school year were Idaho, Alaska and Utah, according to the CDC. These states allow children to be exempted for religious reasons by providing a notarized or signed statement by the parent or legal guardian.

Florida and Georgia report the lowest minimum immunization rates for kindergarteners and allow parents to exempt their children by submitting a form to their child's school or day care center.

Both states reported declines in coverage of the measles, mumps, and rubella vaccine, the most commonly administered vaccine in childhood. In Georgia, MMR prevalence among kindergarteners declined from 93.1% in the 2019-20 school year to 88.4% in the 2023-24 school year, according to the CDC. Florida's rate fell to 88.1% from 93.5% during the same period.

Andy Schoen, a pediatric infectious disease expert in Atlanta, blames Georgia's declining infection rates on families not seeing a pediatrician. National policies regarding exemptions are also important, she said.

“There is a lot of data supporting the fact that vaccination rates are higher when personal belief exemptions are not granted,” he said.

In December, Georgia public health officials issued an advisory saying the state was seeing a significant increase in cases recorded. whooping cough The number of cases has increased compared to last year. Georgia reported 280 cases in 2024, compared to 96 the year before, according to CDC data.

Until 2023, Mississippi was one of the few states that allowed parents to opt out of their children's vaccinations for medical reasons, but only with a doctor's permission. This resulted in the highest vaccination rate in the nation as of the 2023-24 school year.

“This is one of the few things Mississippi has done well,” says Anita Henderson, a pediatrician who has practiced in the southern part of the state for nearly 30 years. On the health front, he said childhood vaccination rates are the state's only “shining star.”

That changed in April 2023, when a federal judge ordered state officials to begin granting religious exemptions. Mr Henderson said the verdict was an encouragement to many families.

“This ruling has led to increased skepticism, hesitancy and lack of confidence in getting vaccinated,” she said.

Since the court order granted religious exemptions, state officials have granted more than 5,000 religious exemptions, according to the state health department. State health official Daniel Edney said most of the requests come from “wealthier” residents living in “pockets” of the state.

“Most people listen to experts from their pediatricians and family physicians to help them stick to vaccination schedules, because that's the best way to protect their children,” he said.

In December, before he resigned as state health officer, Matthew Christiansen said West Virginia's vaccine law, which does not allow for non-medical exemptions, could soon change.

A bill to expand the exemption passed the Legislature last year, but was vetoed by outgoing Republican Gov. Jim Justice. The new governor, Republican Pat Morrissey, has been a vocal critic of vaccine mandates. Just one day after taking office, he issued an executive order requiring him to propose provisions by February 1 to allow for religious and conscientious exemptions.

“I want to send a message that there are exceptions for people who have religious beliefs. We are not going to be an outlier,” he said at a news conference on January 14.

Christiansen said those who advocate personal freedom to refuse to vaccinate their children could ultimately reduce the ability of others to lead fulfilling lives. “For children to contract measles, mumps or polio and be paralyzed for life is a hindrance to their personal freedom and autonomy,” he said.

Anti-vaccine sentiment has been on the rise in Tennessee since the coronavirus pandemic. One group, Stand for Health Freedom, has drafted a letter to state legislators for voters calling for the resignation of Tennessee's medical director of vaccine-preventable diseases and immunization programs. The group said it showed she “does not respect the right to informed consent” of the public.

“This presidential administration seems to feel very strongly that a lot of these issues should be brought back to the states, and they're I feel encouraged,” he said.

Henderson, a Mississippi pediatrician, said that like many effective public health interventions, vaccines are ultimately a victim of their own success. She says most people have never seen a measles or polio outbreak, so they forget how dangerous these diseases are.

“Unfortunately, it may take these diseases to come back to raise awareness of the fact that they are dangerous, deadly and preventable,” she said. . I hope that doesn't happen.




kaiser health newsThis article is republished from khn.org. khn.org is a national newsroom that produces in-depth journalism on health issues and is one of KFF's core operating programs, providing independent information for health policy research, polling, and journalism. It is the source.

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