Press Briefing Transcript

Childhood 2010 NIS Data Interview with Dr. Lance Rodewald

Thursday, September 1, 2011

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[Matthew Reynolds] The National Immunization Survey is a national report card on how we, as a country, are doing with vaccinations. On September 1, CDC released vaccination coverage data for young children 19 to 35 months of age. Today, I’m talking to Lance Rodewald, Director of the Immunization Services Division at CDC’s National Center of Immunization and Respiratory Diseases about this data.

What does the 2010 National Immunization Survey data tell us about childhood immunization rates in the US?

[Dr. Lance Rodewald] So, as a report card for how well children are protected from vaccine-preventable diseases through immunizations, parents, doctors, nurses, and state and local public health professionals get very high marks. The US children are really quite well protected right now. The coverage for vaccines against 14 vaccine-preventable diseases are either stable at high levels or have increased. The newest infant vaccine, rotavirus vaccine, protects against a form of dehydrating gastroenteritis that led to many, many hospitalizations, many emergency department visits, and a great many doctors visits for sick children who are dehydrated. The coverage for the vaccine against that disease went up 15 percentage points, and it seems like just about every month, there’s a new report in Pediatrics or the New England Journal of Medicine that talks about the tremendous impact that that vaccine has had in preventing hospitalizations, emergency department visits, and doctors office visits for sick children.

One important finding is that the disparities by race and ethnicity and even poverty level in the US have either shrunk or diminished. They’ve always been fairly low, but this is good news; the low ones even got lower and some of the disparities we saw were completely eliminated for coverage rates. And so, what that means is that coverage rates for poor children and coverage rates for children of racial or ethnic minorities have increased nicely and so we were very happy to see that.

One other important finding is that only less than one percent of children received no doses of vaccine. This is something that we’d like to see down to zero. It was 0.7 percent so we’d like to keep it at less than one percent and we are happy that parents, you know, want to get their children vaccinated and very few are opting out completely.

Now, we still have some disparities that exist. They tend to be very small but one of the ones that is quite troubling is that nine percent gap by poverty level for rotavirus vaccine. It indicates that we need to work harder, and another thought is that if you have coverage at 90 percent, what that means is that there may be up to around 10 percent of children who don’t get their immunizations in a timely manner. It’s important to keep children vaccinated on time.

We saw one other finding in the survey that I think is quite nice to see. There was a Hib shortage that started in December 2008 and lasted for a year and a half. This vaccine prevents against a horrible disease that causes meningitis, blood infections, and used to be the leading cause of acquired deafness in the United States. When that shortage came in, everybody was scared that children were going to start to get invasive Hib disease. The vaccine shortage was so big that the booster dose had to be cut out and not provided. And what we’re seeing in this report card is that the booster dose is coming back and the primary series that provides the most protection for children stayed very high through the entire year and a half shortage, so we were very pleased to see that.

[Matthew Reynolds] Since vaccination rates for children are high, why do we still need to vaccinate children? I mean, what would happen if we didn’t?

[Dr. Lance Rodewald] That’s a very good question. Every one of the 14 diseases that young children are vaccinated against is a real threat to the health of children; they’re not theoretical risks. Either the virus or the bacteria continues to circulate in the United States or the disease exists in other parts of the world. For example, right now, measles is out of control in many European countries and other places in the world. What that means is that the US is constantly peppered by imported cases of measles that hopefully will not spread, and to the experience that we’ve had now, have not been spreading because children have high protection. If that protection started to flag, then these imported cases of measles would start to spread throughout the childhood population and that could lead to big problems. For example, this year, there’ve been about 200 cases of measles in the United States and 90 percent of them were import-associated.

We’re also seeing pertussis, or whooping cough, all around the United States. This serves as a very serious reminder that it’s important to protect young children because they’re the ones who really have the serious complications from whooping cough so coverage rates need to stay high against that disease. So, in short, if we stop vaccinating, the diseases that are still out there, as all of these are, will simply return.

[Matthew Reynolds] What happens if a child gets behind on the immunization schedule and misses one or more shots? What should parents do?

[Dr. Lance Rodewald] Yeah, the immunization schedule is designed to protect children at as young an age as possible and to keep them protected throughout life. If a child gets behind on immunizations, that means that there’s some risk that the child is not fully protected. So, if that happens, a parent should go to their health care provider for their child and get their child caught up-to-date and get the vaccines that are needed. One nice thing about the immunization schedule and how the vaccines work is that a child would not have to start over from scratch. They would just need to pick up from where they left off before to get themselves up-to-date.

[Matthew Reynolds] If a family wants to vaccinate their child or children but they’re concerned about the cost, what are their options?

[Dr. Lance Rodewald] Well, in the United States, almost all insurance companies pay for childhood immunizations, so that’s great news. The federal Vaccines for Children Program was established in 1993 and implemented in 1994 and it provides free vaccines for children with no health insurance and also for some other financially vulnerable children. Most pediatricians, family physicians, and health departments and community health centers participate in the Vaccines for Children Program and that really helps make vaccines available for all children in the United States.

[Matthew Reynolds] Where can someone get more information about childhood immunization?

[Dr. Lance Rodewald] Your child’s doctor is the best source of information about vaccines and the diseases that these vaccines prevent. There’s also a lot of information available at CDC’s website. This information covers the diseases and the vaccines, and also the Vaccines for Children Program. CDC’s website is www.cdc.gov/vaccines. People can also get help in English and Spanish by calling 1-800-CDC-INFO.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES