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Child vaccination rates dipped into dangerous territory during the first year of the COVID-19 pandemic, when schools were shuttered, and most doctors were only seeing emergency patients.
But instead of recovering after schools reopened in 2021, those historically low rates worsened, according to new data from the federal Centers for Disease Control and Prevention. Experts fear that the skepticism of science and distrust of government that flared up during the pandemic are contributing to the decrease.
According to today’s data, the percentage of U.S. children entering kindergarten with their required immunizations fell to 93% in the 2021-22 school year, 2 percentage points below recommended herd immunity levels of 95% and lower than vaccination rates in 2020-21, when many schools and doctor’s offices were closed.
“While 1 percentage point might not seem concerning, that one percent represents tens of thousands of children who are inadequately protected from diseases we can easily prevent through immunization,” said Dr. Michelle Fiscus, chief medical officer at the Association of Immunization Managers, a nonprofit group of state officials who direct vaccination efforts.
“This national trend is alarming, especially as we see outbreaks of measles in Ohio among children who are too young to be vaccinated and those who are inadequately vaccinated. We need all hands on deck to get these children protected,” Fiscus said.
Public health officials warn that unless child vaccination rates for measles, chicken pox, polio and other diseases are quickly brought back to pre-pandemic levels, outbreaks of preventable diseases — like the measles outbreaks in Ohio and Minnesota in the fall and the polio case in New York last summer — are likely to become commonplace.
While COVID-related disruptions in schools and the health care system may be the primary cause for this recent drop in immunization rates, they’re only part of the reason state-required vaccination rates are trending downward, public health experts say.
They say the politicization of public health and increasing distrust of government have skewed parents’ previously positive attitudes about vaccines for measles, mumps, rubella, chicken pox, tetanus, diphtheria, polio and other childhood diseases that have been all but eradicated.
“I’m trembling in my anxiety about this,” said Dr. William Schaffner, a professor of preventive medicine at the Vanderbilt University School of Medicine.
“Our own success in immunizing children routinely, uniformly against a whole list of diseases that used to be common has resulted in the current generation of moms and dads not knowing much about these diseases, if anything,” he said.
“If you don’t fear the disease and respect the vaccines,” he added, “you may not adhere to state laws requiring them.”
In general, the public’s willingness to follow public health requirements has been waning since the COVID-19 pandemic began, said Dr. Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officers.
The political divisiveness that erupted over COVID quarantines, masking and vaccines, he said, may be spilling over into what has been a widely accepted public health policy of protecting children from infectious diseases.
The CDC estimates that vaccinating children born from 1994 to 2018 will prevent 472 million illnesses, nearly 30 million hospitalizations and more than a million deaths. The state-run vaccination programs are also projected to save $479 billion in health care and other direct costs.
In 2019, a single measles outbreak of 72 cases in Washington state cost $3.4 million, CDC researchers estimated, with most of the costs incurred by local public health agencies.
State immunization rates vary widely. For the 2021-22 school year, Alaska, the District of Columbia, Wisconsin, Georgia, Idaho, Kentucky and Ohio had the lowest rates. New York, Rhode Island, West Virginia, Delaware, California, Massachusetts and Nebraska had the highest rates.