Vaccines Save Lives. Full Stop.

Health and Well-Being Matter is the monthly blog of the Director of the Office of Disease Prevention and Health Promotion. 

In August, we observe National Immunization Awareness Month (NIAM) and promote the importance of vaccinations in improving individual and community health and resilience. It has consistently become a more critical issue, as doubt concerning the importance of vaccines — including for children — continues to increase. As childhood vaccination rates decline in the U.S., the urgency to help parents and caregivers understand the truth about the role vaccines play in supporting children’s health is all the more imperative. With the start of the new school year, doing so becomes even more relevant if we are to avoid outbreaks of preventable diseases.

Recently, Gallup released a survey of U.S. adults' views on childhood vaccinations. In it, only 40 percent of respondents reported that it’s extremely important for parents to have their children vaccinated. That figure continues a 2-decade downward trend in positive perspectives related to childhood vaccinations (in 2019, 58 percent viewed childhood vaccinations as extremely important — and in 2001, 64 percent said the same). Though they haven’t dropped as precipitously as beliefs in vaccines’ importance, actual vaccination rates for several diseases have also decreased. The Centers for Disease Control and Prevention (CDC) reports that nationwide vaccination coverage among kindergarten children for measles, mumps, and rubella vaccine (MMR), diphtheria, tetanus, and acellular pertussis vaccine (DTaP), poliovirus vaccine (polio), and varicella vaccine (VAR) has fallen below Healthy People 2030 targets. 

Given the disrupted access to clinical preventive services overall due to the pandemic, it may be tempting to interpret the decrease in vaccination rates as simply another manifestation of altered routines. But when we look at CDC's estimated percentage of students requesting vaccine exemptions during the 2021-2022 school year, we note the following: 

• In the 2022-23 school year, 3 percent of kindergartners nationwide had an exemption from 1 or more required vaccines, with exemptions ranging from less than 0.1 percent in West Virginia to a high of 12.1 percent in Idaho. 
• The national rate of vaccine exemptions was up from 2.6 percent reported during the 2021–22 school year. 
• Exemptions for 1 or more vaccines increased in 40 states and the District of Columbia, with more than 90 percent of exemptions requested for nonmedical reasons. 

Strikingly, 3.9 percent of all kindergarteners without exemptions were not fully vaccinated with MMR. In other words, many children were not vaccinated even though there wasn’t a declared medical reason.

Although the data doesn’t tell us exactly why parents choose not to have their children vaccinated — be it due to ideological reasons, barriers to care, or inconvenience — the potential results are the same. Plainly, reduced rates of vaccination increase the risk of outbreaks of vaccine-preventable diseases, disease-related complications, and mortality. Health professionals play an important role in mitigating vaccine hesitancy and increasing confidence in vaccinations by sharing factual information about the benefits and risks of vaccination — and by sympathetically encouraging those they serve to ensure their children are up to date on vaccinations. Additionally, helping to inform parents of the importance of staying up to date on adult vaccinations like influenza, RSV, and COVID-19 can prevent severe morbidity and mortality.

Our office maintains several excellent resources to help professionals promote increased vaccine uptake. Healthy People 2030 Evidence-Based Resources (EBRs) for vaccination are published reviews of intervention evaluations and studies to improve health. For ease of use, EBRs are organized into intuitive topic areas.

Health care professionals may want to direct those they serve to ODPHP’s MyHealthfinder website, particularly its pages on vaccination. The MyHealthfinder open access online resource provides easy-to-understand information on preventive health care, with over 100 plain language health and wellness topics and tools in English and Spanish. It also includes an assessment tool that offers tailored recommendations for clinical preventive services based on a person’s age, sex, and pregnancy status. Organizations can also use the MyHealthfinder API (application programming interface) to seamlessly add MyHealthfinder content to their website to share evidence-based health information with the people who need it most — or to create a unique tool supported by plain language health content.

The CDC offers several Immunization Education and Training courses, as well as tips and guidance on making a medical practice a supportive and welcoming space for vaccine questions and concerns. They also provide easy-to-use vaccine schedules that providers can display on their website or produce in hardcopy. Because certain ages are best for receiving specific vaccines due to factors like immune system response and exposure risks, adhering to a prescribed vaccination schedule will increase vaccine effectiveness. 

To help get everyone who missed vaccinations “back on track” with routine immunizations, check out the Routine Immunizations on Schedule for Everyone (RISE) program. RISE offers proven strategies, fact sheets, and other materials to restart a lapsed vaccination schedule. Providers will find that tools like the PneumoRecs VaxAdvisor App can also help them make informed and timely vaccine recommendations to their patients.  

Vaccines save lives. Full stop. Receiving vaccinations on schedule protects not just an individual but those around them, particularly the most vulnerable people in their lives. Providing the facts about the risks and benefits associated with vaccines, with a sympathetic ear to a person’s perspective, can make all the difference. Encourage everyone you know or serve to speak with their provider, help them find trusted sources of information, and provide opportunities for them to get on schedule with their vaccines. Vaccine advocacy can and does make a significant impact in safeguarding public health.

We must turn the trajectory of vaccine confidence and acceptance around.

Yours in health,
Paul 

Paul Reed, MD
Rear Admiral, U.S. Public Health Service
Deputy Assistant Secretary for Health
Director, Office of Disease Prevention and Health Promotion

In Officio Salutis