Immunizations are a vital tool for community health, a line of defense against some of the most deadly and debilitating diseases known. It is particularly important to vaccinate small children, because they are both more vulnerable and contribute greatly to the spread of disease.
Virginia's vaccination rate for children has fluctuated in recent years, within a range of 70 to 82 percent. The state has taken steps to improve the vaccination rate by mandating vaccinations for students entering both kindergarten and college, and by putting Healthy Virginians and the federal Healthy People programs in place. But child immunization rates have dropped again and rates for adults 65 and older have also decreased, putting both populations at increased risk for serious illness.
Why is This Important?
Immunizations work by mobilizing the body's natural defenses against disease. They can prevent disability and death from certain diseases and can help control the spread of infections within communities. Vaccines now control diseases that once spread quickly and killed thousands.
Vaccines are given early in life because many vaccine-preventable diseases are more common and more deadly among infants and small children. Childhood immunization is also an important step in maintaining high community vaccination levels, which prevent outbreaks of such diseases. Adult immunizations are equally key. Some adults were never immunized as children and need to catch up; others need updated vaccines for diseases (e.g., influenza) that mutate over time, rendering older vaccinations ineffective.
How is Virginia Doing?
Successful child immunization is defined by the percent of children ages 19 to 35 months who have received:
- four or more doses of DTP
- three or more doses of poliovirus vaccine
- one or more doses of measles-containing vaccine
- three or more doses of HIB
- three or more doses of HepB vaccine
- one or more doses of varicella vaccine
Virginia's child vaccination rate dropped from 77.1 percent in 2011 to 71.1 percent in 2012; this rate ranked Virginia 31st in the nation. Hawaii had the highest immunization rate at 82.4 percent. Virginia's rate was lower than all of its peer states: North Carolina (76.2%), Tennessee (74.6%), and Maryland (73.0%). The national immunization rate stood at 71.9 percent.
Data from the Behavioral Risk Factor Surveillance Survey (BRFSS) and also reported by Virginia's Department of Health shows that influenza and pneumococcal vaccination rates in adults age 65 years and older generally decreased from 2010 to 2012. Flu vaccinations dropped from 69 percent in 2010 to 63.3 percent in 2011 and further to 60.1 percent in 2012. Pneumonia vaccinations stayed about 72.0 percent from 2010 through 2011, but declined to 65.7 percent in 2012.
What Influences the Immunization Rate?
Several factors influence immunization rates.
Poverty/access to care issues: Fragmented health care systems, insurance coverage restrictions, provider unwillingness to deliver vaccines in-office, incomplete availability of vaccine for children program services, and referral to other agencies for vaccine delivery.
Cultural approaches to health care: New and widely reported fears of harmful effects from immunizations, low family prioritization for vaccine delivery, misunderstanding of vaccine relevance, and lack of trust in the medical community.
Missed opportunities: Provider manufacturer obstacles, vaccine not available, vaccine shortage (manufacturer), reimbursement deficiencies, lack of simultaneous administration, invalid contraindications, and misinformation about vaccine needs.
What is the State's Role?
One of the Virginia Department of Health's goals is to reduce the number of cases of vaccine-preventable diseases. Virginia is working to:
- ensure that 2-year-olds are appropriately vaccinated
- increase the number of adults who get annual flu and pneumococcal vaccinations
- help achieve the World Health Organization's goal of global polio eradication
- reduce the cumulative global measles-related mortality rate
- improve vaccine safety surveillance.
Virginia is also working with the federal government's Healthy People 2020 initiative, whose goal is for 80 percent of children aged 19-35 months to be immunized against DTP, polio, MMR, HIB, hepatitis B, varicella, and PCV.
The Commonwealth requires all children entering kindergarten to be vaccinated. Local health departments administer vaccinations and Medicaid assists with vaccination payments. Before beginning college in Virginia, all entering freshman must provide up-to-date shot records and have the meningitis vaccination or sign a waiver of refusal. The Division for the Aging in the Department for Aging and Rehabilitative Services helps seniors get vaccinated, as they are particularly vulnerable to serious complications from the flu virus.
State rankings are ordered so that #1 is understood to be the best.
Data and Definitions
Centers for Disease Control and Prevention (CDC)
This survey includes a margin of error ranging from 1.1 percent on national estimates and up to 9.9 percent for some state estimates.
Estimated vaccine coverage with 4:3:1:3:3:1, which includes: 4 or more doses of Diphtheria, Tetanus & Acellular Pertussis Vaccine (DTaP); 3 or more doses of Poliovirus; 1 or more doses of Measles, Mumps & Rubella Vaccine (MMR); 3 or more doses of Haemophilus Influenzae Type b (Hib); and 3 or more doses of Hepatitis B Virus (HepB) and 1 or more doses of varicella vaccine.
Behavioral Risk Factor Surveillance Survey (BRFSS), Influenza and Pneumococcal Vaccine Coverage for Persons 65 Years and Older.
Virginia Performs, Virginia Department of Health, Key Measures.
See the Data Sources and Updates Calendar for a detailed list of the data resources used for indicator measures on Virginia Performs.