Health and Family

Immunization

Immunization

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 65 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. In contrast, immunization rates for adults 65 and older have generally increased, helping keep potentially deadly illnesses under better control in our senior populations.

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?

Children

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.

After years of steady decline, in 2010 Virginia began to reverse this trend; by 2011, coverage for childhood immunizations was back up to 77.1 percent. Despite an improvement of 3 percentage points over the previous year, this rate ranked Virginia just 26th best in the nation; North Dakota had the highest immunization rate at 84.8 percent. Virginia's rate was lower than Maryland (82.1%) but higher than North Carolina (75.3%) and Tennessee (75.1%). The national immunization rate stood at 77.6 percent.

Adults

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 are generally trending upward.  Flu vaccinations improved overall from 65 percent in 2002 to 69 percent in 2010. Pneumonia vaccinations climbed from 61.6 percent in 2002 to 72.1 percent in 2010.

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?

The Healthy Virginians' 2010 goal 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.