Vaccines work, but parents still don’t participate

Since it was first implemented in 1994, the Vaccines for Children (VFC) program is estimated to have prevented 322 million illnesses, 21 million hospitalizations, and 732,000 deaths at a net savings of $295 billion in direct costs and $1.38 trillion in total societal costs, making it one of the most effective tools for improving the health of our children, according to a recent report from the Centers for Disease Control and Prevention.

One of the reasons for its high efficacy, the report says, is that the VFC program removed financial and logistical barriers hindering vaccination for low-income children, thereby helping to keep coverage for many childhood vaccine series near or above 90%.

In spite of such proven success, many children still go unvaccinated, whether because of caregivers’ religious beliefs, fears of adverse effects or an association with autism, or other personal beliefs. Even full-scale epidemics don’t seem to change vaccination rates.

For example, in a study presented at this year’s Pediatric Academic Societies annual meeting in Vancouver, British Columbia, researchers looked at infant DTaP (diphtheria, tetanus, and acellular pertussis) immunization rates surrounding an outbreak of pertussis (whooping cough) in the state of Washington in 2012. They found no significant difference in vaccination rates before (67.4%) and during (69.5%) the epidemic among the approximately 80,000 infants aged 3 to 8 months included in the study (absolute difference, 2.1%; 95% confidence interval, -1.6, 5.9).

Experts are finding that the benefits of vaccines are far reaching. A recent randomized trial found that the Tdap (tetanus, diphtheria, and acellular pertussis) vaccine protects a pregnant woman as well as her unborn child against pertussis after birth. Newborns are particularly vulnerable to pertussis until they are old enough to begin the childhood DTaP vaccine series.

Researchers from Baylor College of Medicine in Houston, Texas, gave the Tdap vaccine to 33 pregnant women and a placebo shot to another 15 pregnant women. The babies born to the vaccinated moms had protective levels of antibodies in their blood for the first 2 months of life, essentially protecting the infants until the DTaP childhood vaccination series could begin. No adverse events occurred, and the Tdap vaccine did not alter infant response to the DTaP series. 

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics eConsult.