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 also contribute greatly to the spread of disease.
Child immunization rates have been improving over the last two years, but adult immunization trends have been uneven and differ for flu and pneumonia.
Why is This Important?
Immunizations work by mobilizing the body's natural defenses against disease. They help control the spread of infections within communities and can prevent disability and death from certain diseases. Vaccines now control diseases, such as influenza, that once spread quickly and killed hundreds of thousands.
Many 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?
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 this rate by expanding mandated vaccinations to students entering both kindergarten and college, and by putting Healthy Virginians and the federal Healthy People programs in place.
Although there has been some improvement in both child and adult immunization rates this year, most are still below earlier levels and indicate uneven performance overall.
- four or more doses of DTaP
- 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 rose from 74.6 percent in 2013 to 79.3 percent in 2014 -- above the national average and lifting Virginia's national rank to 9th best. Maine had the highest child immunization rate in 2014 at 87.3 percent. Virginia's rate was higher than Tennessee (72.6%) and Maryland (77.8%), but lower than North Carolina (83.0%). The national immunization rate stood at 74.6 percent.
Data from the Behavioral Risk Factor Surveillance Survey (BRFSS) and also reported by Virginia's Department of Health shows that influenza vaccination rates in adults age 65 years and older declined from 63.3 percent in 2011 to 59.2 percent in 2014. After dropping from 72.0 percent in 2011 to 65.7 percent in 2012, pneumonia vaccinations rebounded to a new high of 73.4% in 2014.
What Influences the Immunization Rate?
Several factors influence immunization rates.
Poverty/access to care issues: Fragmented health care systems, provider unwillingness to deliver vaccines in-office, incomplete availability of vaccines for children's 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 eligible families 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 a 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)
NOTES: This survey includes a margin of error ranging from 1.4 percent on national estimates and up to 9.2 percent for some state estimates.
Estimates / comparisons before 2011 were dropped due to sampling methodology changes.
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), Adult Vaccination Coverage Reported via BRFSS.
See the Data Sources and Updates Calendar for a detailed list of the data resources used for indicator measures on Virginia Performs.