Mark Probert
August 1st 03, 07:02 PM
CDC Focuses on Late-Vaccinated Toddlers
Fri Aug 1, 9:12 AM ET
By LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Mary-Clayton Enderlein worried when a baby brought to her
son's play date had a very distinctive cough — a high-pitched "whoop"
while gasping for air. It might indeed be whooping cough, the baby's
mother agreed, explaining that the family didn't believe in vaccines
against that or any other disease.
A week later, a now-coughing Enderlein gave birth to her second son —
and the newborn promptly sickened, too. Little Colin spent 10 days in
intensive care in a Seattle hospital, turning blue as 50 coughs in a row
would wrack his body. It took months for Enderlein, Colin and the
playmate who infected them to all recover.
About 75 percent of the nation's toddlers get vaccinated on time,
protecting them from getting — and spreading — nine different diseases.
But coverage varies widely among states and major cities, with pockets
of the country where far too few youngsters are up-to-date on their
shots, federal health officials warned Thursday as they urged
communities to eliminate those disparities.
As Enderlein's scare shows, getting shots late or not at all doesn't
just endanger the unvaccinated child. He or she in turn can spread
disease to people with weakened immune systems like elderly
grandparents, friends with cancer, pregnant neighbors or younger
children — a reason that so-called community immunity is vital to public
health.
Last year, Colorado had the most immunization laggards, with just 62.7
percent of toddlers getting all their shots, the Centers for Disease
Control and Prevention (news - web sites) said.
Nine other states have fewer than 70 percent on-time toddler
vaccinations: Arizona, Idaho, Kansas, Louisiana, Montana, New Mexico,
Oklahoma, Texas and Washington.
Massachusetts was doing the best job, immunizing 86 percent of toddlers
on time. Also raising the national average were the five other New
England states as well as North Carolina, Georgia, Michigan, Wisconsin
and South Dakota — states that immunize more than 80 percent of toddlers
on time.
There was even more variation when CDC checked records of some large
cities. In Newark, N.J., for example, just 57.5 percent of toddlers had
up-to-date shots.
The government's goal is that by 2010, 80 percent of all toddlers get
on-time vaccinations against diphtheria, whooping cough, tetanus,
meningitis-causing Haemophilus influenza or Hib, hepatitis B, polio
(news - web sites), measles, mumps and rubella.
Nationally, vaccination rates for those diseases have remained about the
same for the last few years, as doctors struggled to keep toddlers up to
date amid shortages of some key shots. So far this year, supplies seem
adequate.
In addition to the nine most-measured vaccines, toddlers are supposed to
get shots against chickenpox and the pneumococcal vaccine that protects
against certain types of meningitis and ear infections. Last year, a
record 81 percent of toddlers received the chickenpox inoculation, up
from 76 percent in 2001, the CDC said. And 41 percent of youngsters
received the pneumococcal immunization, the first time the CDC ever
counted this vaccine, which hit the market in 2000.
It's not clear why some states have a harder time vaccinating, said CDC
immunization chief Dr. Walter Orenstein.
Vaccine-phobic parents like the mother Enderlein encountered are a
minority — well over 90 percent of infants get vaccinated. Instead,
Orenstein said, simply remembering to keep up with the roughly 20 doses
required by age 2 is hard for parents and doctors alike.
CDC's advice:
_States should identify communities where vaccination rates are
significantly below the national average and eliminate the disparities.
Poorer children are most likely to be missed.
_Parents should get their child's immunization records and ask if the
child is up to date every time they see the pediatrician.
_Doctors should check vaccine records even if the child is just in for,
say, an ear exam. Any visit is an opportunity to give a missed vaccine.
_States should invest in computerized vaccination registries, which can
automatically send parents reminders about overdue shots and help keep
physician records up to date.
"If we let down our guard ... vaccine-preventable diseases will return,"
Orenstein warned.
Fri Aug 1, 9:12 AM ET
By LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Mary-Clayton Enderlein worried when a baby brought to her
son's play date had a very distinctive cough — a high-pitched "whoop"
while gasping for air. It might indeed be whooping cough, the baby's
mother agreed, explaining that the family didn't believe in vaccines
against that or any other disease.
A week later, a now-coughing Enderlein gave birth to her second son —
and the newborn promptly sickened, too. Little Colin spent 10 days in
intensive care in a Seattle hospital, turning blue as 50 coughs in a row
would wrack his body. It took months for Enderlein, Colin and the
playmate who infected them to all recover.
About 75 percent of the nation's toddlers get vaccinated on time,
protecting them from getting — and spreading — nine different diseases.
But coverage varies widely among states and major cities, with pockets
of the country where far too few youngsters are up-to-date on their
shots, federal health officials warned Thursday as they urged
communities to eliminate those disparities.
As Enderlein's scare shows, getting shots late or not at all doesn't
just endanger the unvaccinated child. He or she in turn can spread
disease to people with weakened immune systems like elderly
grandparents, friends with cancer, pregnant neighbors or younger
children — a reason that so-called community immunity is vital to public
health.
Last year, Colorado had the most immunization laggards, with just 62.7
percent of toddlers getting all their shots, the Centers for Disease
Control and Prevention (news - web sites) said.
Nine other states have fewer than 70 percent on-time toddler
vaccinations: Arizona, Idaho, Kansas, Louisiana, Montana, New Mexico,
Oklahoma, Texas and Washington.
Massachusetts was doing the best job, immunizing 86 percent of toddlers
on time. Also raising the national average were the five other New
England states as well as North Carolina, Georgia, Michigan, Wisconsin
and South Dakota — states that immunize more than 80 percent of toddlers
on time.
There was even more variation when CDC checked records of some large
cities. In Newark, N.J., for example, just 57.5 percent of toddlers had
up-to-date shots.
The government's goal is that by 2010, 80 percent of all toddlers get
on-time vaccinations against diphtheria, whooping cough, tetanus,
meningitis-causing Haemophilus influenza or Hib, hepatitis B, polio
(news - web sites), measles, mumps and rubella.
Nationally, vaccination rates for those diseases have remained about the
same for the last few years, as doctors struggled to keep toddlers up to
date amid shortages of some key shots. So far this year, supplies seem
adequate.
In addition to the nine most-measured vaccines, toddlers are supposed to
get shots against chickenpox and the pneumococcal vaccine that protects
against certain types of meningitis and ear infections. Last year, a
record 81 percent of toddlers received the chickenpox inoculation, up
from 76 percent in 2001, the CDC said. And 41 percent of youngsters
received the pneumococcal immunization, the first time the CDC ever
counted this vaccine, which hit the market in 2000.
It's not clear why some states have a harder time vaccinating, said CDC
immunization chief Dr. Walter Orenstein.
Vaccine-phobic parents like the mother Enderlein encountered are a
minority — well over 90 percent of infants get vaccinated. Instead,
Orenstein said, simply remembering to keep up with the roughly 20 doses
required by age 2 is hard for parents and doctors alike.
CDC's advice:
_States should identify communities where vaccination rates are
significantly below the national average and eliminate the disparities.
Poorer children are most likely to be missed.
_Parents should get their child's immunization records and ask if the
child is up to date every time they see the pediatrician.
_Doctors should check vaccine records even if the child is just in for,
say, an ear exam. Any visit is an opportunity to give a missed vaccine.
_States should invest in computerized vaccination registries, which can
automatically send parents reminders about overdue shots and help keep
physician records up to date.
"If we let down our guard ... vaccine-preventable diseases will return,"
Orenstein warned.