August is National Immunizations Awareness month. Vaccinations have been a hot topic over the past year and a half. They’ve been around much longer than the COVID-19 virus, though.
Vaccines have been utilized for more than a century to curb and sometimes even eliminate the spread of infectious diseases. Each year, various types of immunizations prevent 2.7 million cases of measles, two million cases of neonatal tetanus, one million cases of pertussis, 600,000 cases of paralytic poliomyelitis and 300,000 cases of diphtheria.
Missing an immunization or two might not seem like a big deal to some, but approximately 50,000 adults and 300 children died from vaccine-preventable diseases every year in the U.S. prior to the COVID-19 pandemic. In addition to influenza and chickenpox, vaccine-preventable diseases include diphtheria and human papillomavirus (HPV).
The COVID-19 Effect
Although debate continues to rage on about the efficiency of various COVID-19 immunizations, about 80 percent of Americans received at least one dose. However, that number is much lower in children, especially the youngest. Roughly three percent of children under the age of five have received at least one COVID-19 dose, increasing to about 40 percent for children ages five to 11 and 70 percent for 12-17-year-olds.
Along with in-person learning, the COVID-19 pandemic disrupted routine well-child visits, meaning many children in the United States also are behind on previously routine vaccines. Around four in 10 parents say their kids have missed immunizations due to the pandemic, and studies have shown that about one-fourth of preschool children are missing at least one routine vaccination.
Advantages of Vaccines for Adults
Along with preventing disease in those who receive them, vaccination offers a multitude of advantages, including:
- Reducing the likelihood of disease transmission
- Decreasing antibiotic use
- Lowering diagnostics and treatment costs
- Reducing numbers of ambulatory care visits
- Decreasing need for medical interventions and hospitalizations
Since the widespread use of vaccines, multiple diseases — endemic polio, smallpox, rubella and congenital rubella syndrome — have been eliminated in the U.S. Measles vaccines alone are estimated to have prevented more than 21 million deaths between 2000 and 2017.
As with the primary COVID-19 shots, vaccines lessen the effects of some preventable diseases and help mitigate their spreading. They also prepare your body to fight the disease faster and more effectively through stimulating a body’s natural defenses.
Benefits of Vaccines for Children
Routine vaccinations during childhood help prevent 14 different potentially life-threatening diseases. Across the globe, they prevent an estimated 2.5 million deaths each year among children aged five and younger. Even vaccines given to pregnant women help protect their baby by passing on antibodies.
Without these vaccines, young children have the highest risks of complications that could lead to hospitalization or death. According to the Centers for Disease Control and Prevention (CDC), flu-related hospitalizations in the U.S from 2010 to 2018 among children younger than five years of age have ranged from 7,000-26,000.
Lack of certain vaccines may also have a detrimental effect on a child’s education. For example, some schools require a certificate of immunization to enroll, and, in some cases, a child with a vaccine-preventable disease can be denied attendance at schools or childcare facilities.
Some parents cite safety concerns as the reason for not getting their child’s vaccination. However, as noted by the National Foundation for Infectious Diseases (NFID), all approved vaccines in the U.S. are required to go through extensive safety testing before they are available for use. After a vaccine is approved by the Food and Drug Administration (FDA), four separate surveillance systems are used to monitor vaccine efficacy and safety.
Recommended Vaccination and Immunization Schedules
Knowing what vaccines are appropriate at what age(s) and how many doses are needed can be confusing. The CDC offers the following list of recommended vaccines for children by age:
Birth – Age Two
- Chickenpox (varicella) vaccine: at 12 through 15 months
- Diphtheria, tetanus, and pertussis (DTaP) vaccine: at two months, four months, six months and 15 through 18 months
- Flu vaccine: every year by the end of October, if possible, starting at six months
- Haemophilus influenzae type b (Hib) vaccine: at two months, four months, six months (if needed; depends on brand) and 12 through 15 months
- Hepatitis A vaccine: At 12 through 23 months and a second dose six months following first dose
- Hepatitis B vaccine: Shortly after birth, at one through two months and at six through 18 months
- Measles, mumps, rubella (MMR) vaccine: At 12 through 15 months; however, infants six through 11 months old should have one dose of MMR vaccine before traveling abroad
- Pneumococcal (PCV13) vaccine: At two months, four months, six months and 12 through 15 months
- Polio (IPV) vaccine: At two months, four months and six through 18 months
- Rotavirus (RV) vaccine: At two months and four months (for Rotarix brand); or two months, four months and six months (for RotaTeq brand)
Ages Three – 10
- Chickenpox (varicella) vaccine: at four through six years
- Diphtheria, tetanus and pertussis (DTaP) vaccine: at four through six years
- Flu vaccine: every year by the end of October, if possible
- Measles, mumps, rubella (MMR) vaccine: at four through six years
- Polio (IPV) vaccine: at four through six years
Ages 11 – 18
- Flu vaccine: every year by the end of October, if possible
- Human papillomavirus (HPV) vaccine: at 11 through 12 years and a second dose six-12 months following the first dose
- Meningococcal conjugate vaccine: at 11 through 12 years and at 16 years
- Serogroup B meningococcal vaccine: may be given at 16 through 23 years
- Tetanus, diphtheria and pertussis (Tdap) vaccine: At 11 through 12 years
The CDC also offers an up-to-date catch-up immunization schedule for children and adolescents who start late or are more than one month behind on their vaccines. Children who have a weakened immune system due to a chronic condition might not receive certain vaccines.
Utilizing a Communication Strategy to Increase Child Vaccination Rates
Some parents don’t have their child(ren) immunized due to vaccine hesitancy. Others might not think they can afford them. However, there is a federally funded program — Vaccines for Children — that provides vaccines at no cost to children from low-income families.
Others might simply not be aware that their child isn’t up-to-date on his or her immunizations. That’s why it’s important for pediatricians and other healthcare providers to develop a detailed communication plan that will engage their young patients and increase vaccination compliance rates. It should be based on a recommended schedule designed to work best with a child’s immune system at certain ages and at specific time intervals between doses.
Whether it’s automated text messaging, marketing flyers or some other form of communication, the most effective way to influence vaccination rates is to be specific and clear about what patients — in this case, their parents — need to do for a vaccine. It’s also important to educate these parents with clear messaging about the benefits such vaccines provide. Be clear about how their decision to receive or forgo a vaccination for their child impacts the health of their family, friends and community at large.
Another way to increase vaccination rates for pediatric patients is to leverage behavioral economics to drive action by their parents. Behavioral economics combines decision-making, economics, judgment and psychological insights to better understand human behavior. Many scholars in healthcare believe the key to driving change is by using incentives and disincentives to affect different and better human behavior.
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