CDC Says 1 in 4 Toddler Behind in Vax

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Registered: 12-14-2005
CDC Says 1 in 4 Toddler Behind in Vax
1
Tue, 04-29-2008 - 12:12pm

Release Date:April 29, 2008

CDC Says One-Fourth of Toddlers Behind on Vaccinations
By Lisa Esposito, Editor
Health Behavior News Service

Your toddler might be improperly vaccinated, even if she’s had every immunization the government recommends, according to a new study from the Centers for Disease Control and Prevention.

More than one in four children are out of compliance with U.S. vaccination guidelines, say researchers led by Elizabeth Luman, Ph.D., of the National Center for Immunization and Respiratory Diseases.

The CDC researchers measured vaccine coverage for more than 17,000 2-year-old children against federal guidelines from the Advisory Committee on Immunization Practices (ACIP). The advisors make recommendations for routine childhood vaccinations based on safety and efficacy studies.

For 50 years, the U.S. government has counted missed vaccine doses to measure compliance, but that standard significantly underestimates the problem, according to the new research.

Government figures do not account for other vaccine lapses — like doses given at the wrong age or at wrong intervals. By factoring these in, the study found that compliance drops to only 72 percent — 9 percent lower than previously thought.

“We were surprised that accounting for other recommendations affected results so much,” Luman said. She added that many lay people and health workers wrongly believe that the government bases estimates of vaccine coverage on all the ACIP guidelines.

The study appears in the June issue of the American Journal of Preventive Medicine. The CDC analysis relies on vaccination reports from families who participated in the 2005 National Immunization Survey, which randomly surveyed households with children, then followed up with their vaccine providers.

Missed doses account for two-thirds of vaccine lapses, according to the new estimate.

The study also revealed that some children get their shots too early. For instance, about 3 percent of children had their last hepatitis B vaccines prior to age 6 months, the minimum recommended for that immunization. Other toddlers received their first measles vaccine while their mother’s antibodies still protected them, in effect wasting that dose.

Another lapse — getting serial doses too close together — affects 3 percent of children.

Outbreaks of vaccine-preventable disease have been in the news lately. Were missed doses or mis-timed doses an issue?

In these cases, the problem was children who had received no vaccinations whatsoever, said Jane Seward, deputy director of the Division of Viral Diseases in the National Center for Immunization and Respiratory Diseases.

“During recent measles outbreaks in San Diego, Arizona, and Wisconsin, all cases have occurred among individuals who had not received any measles vaccine,” Seward said.

Reflecting the new study findings, “some of these measles cases represent missed opportunities in both children and adults,” Seward said, while “the remaining cases occurred in infants too young to have been vaccinated or among children whose parents had chosen not to have their children vaccinated because of personal or religious beliefs.”

The CDC researchers say they did not design the study to measure public health outcomes. “We didn’t look at impact on disease; we were really focused on vaccination status of 2-year-olds,” Luman said.

Denice Cora-Bramble, M.D., of the Children’s National Medical Center, in Washington, D.C., deals with these issues in her work every day.

“I respect the general findings, but then we have to walk over to the clinical setting,” she said. “If a kid comes in seven days too early, but the physician thinks they won’t come back, do you send them home?” said Cora-Bramble, who was unaffiliated with the CDC research.

Luman acknowledges this real-life dilemma: “It’s most important that kids get all the doses they’re supposed to have,” she said. “Providers sometimes have to do a balancing act: avoiding missed opportunities versus giving valid vaccinations. But for the 8 percent of children who received an invalid dose, official guidelines call for those vaccinations to be repeated.”

Some of these children might need revaccination before they can start school, Luman said.

Cora-Bramble, who is executive director of the Goldberg Center for Community Pediatric Health, said the study covers new ground and is particularly relevant to her organization, which is working to improve its immunization rates through mobile health vans and other outreach and follow-up efforts.

“Vaccine compliance is an important benchmark for pediatricians,” Cora-Bramble said.
“These are some real issues that we struggle with as clinicians.”

“I have two kids, and from a parent’s point of view, it can be hard, logistically, to come in when scheduled,” Luman said. “But I know how important timely vaccination is for the health of my children and my community.”

http://www.hbns.org/getDocument.cfm?documentID=1702






iVillage Member
Registered: 12-14-2005
Tue, 04-29-2008 - 12:27pm

"Other toddlers received their first measles vaccine while their mother’s antibodies still protected them, in effect wasting that dose."

The reason children under one, who can not be vaccinated, are getting the measles is because of vaccination. Their Mother's were vaccinated and therefore have low antibody levels to cross the placenta and protect them. Only Mother's who get the wild measles have high antibody levels to cross through the placenta.

Let's not forget the role formula plays into the measles into the equation also when there are such abysmal rates of breastfeeding for the first 6 months exclusively and the first year of life. BM also passes measles anitbodies to an infant.

Sources because someone will ask:

"In addition, measles susceptibility of infants younger than 1 year of age may have increased. During the 1989–1991 measles resurgence, incidence rates for infants were more than twice as high as those in any other age group. The mothers of many infants who developed measles were young, and their measles immunity was most often due to vaccination rather than infection with wild virus. As a result, a smaller amount of antibody was transferred across the placenta to the fetus, compared with antibody transfer from mothers who had higher antibody titers resulting from wild-virus infection. The lower quantity of antibody resulted in immunity that waned more rapidly, making infants susceptible at a younger age than in the past." CDC Pink Book (http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf)

"When compared to their offspring, the greater proportion of mothers testing positive for measles antibodies suggests that breast milk protects against measles. Based on these findings, the researchers recommend that all health workers encourage mothers in Nigeria to breast feed their infants to protect them against measles infection."
AFRICAN JOURNAL OF MEDICINE AND MEDICAL SCIENCES, 1995 Dec;24(4):385-8.
http://www.popline.org/docs/1185/121612.html

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"The CDC researchers say they did not design the study to measure public health outcomes. “We didn’t look at impact on disease; we were really focused on vaccination status of 2-year-olds,”"

Why didn't they measure public health outcomes? And if you did not measure them why then draw correlations to what's going on in San Diego?